GOUT

Question 1

DEFINE

Answer 1

INFLAMMATORY DISEASE CAUSED BY DEPOSITION OF MONOSODIUM URATE CRSYTALS IN AND AROUND SYNOVIAL JOINT LEADING TO RECURRENT ATTACK OF ACUTE SYNOVITIS.

Question 2

CLASSSIFICATION

Answer 2

PRIMARY GOUT
SECONDARY GOUT

Question 3

CAUSE OF GOUT

Answer 3

DIMINISHED RENAL EXCRETION -
RENAL FAILURE
LEAD TOXICITY
LACTIC ACIDOSIS
ALCOHOL
DRUGS- CYCLOSPORINE , ASPIRIN, NICOTINIC ACID, DIURETICS , ETHAMBUTOL@ CANDLE

OVER PRODUCTION OF URIC ACID
PSORIASIS
LEISCH NYHANN SYNDROME
GSD

Question 4

CLINICAL FEATURES

Answer 4

MALE ,OBESE ,HYPERTENSIVE ,ALCOHOLIC

PRESENTS WITH
ACUTE =
SUDDEN ONSET OF SEVERE JOINT PAIN
PAIN PRECIPITATED BY MINOR TRAUMA , SURGERY
SKIN IS RED, SHINY , SWOLLEN , HOT
AFFECTS METACARPOPHALANGEAL JOINT OF BIG TOE
SOMETIMES MORE THAN ONE JOINT MAY GET AFFECTED

CHRONIC =
RECURRENT ACUTE ATTACK
LARGE TOPHI
URIC ACID STONES

Question 5

INVESTIGATION

Answer 5

SERUM URIC ACID
SYNOVIAL FLUID - NEGATIVE BIFRINGENT URATE CRYSTALS ON POLARISING MICROSCOPE
RFT
LIPID PROFILE
INCREASE ESR , CRP
X RAY

Question 6

X RAY

Answer 6

ACUTE - SOFT TISSUE SWELLING
CHRONIC - TOPHI , JOINT SPACE NARROWING

Question 7

MANAGEMENT

Answer 7

ACUTE ATTACK
INTERVAL THERAPY
SURGERY

Question 8

ACUTE ATTACK

Answer 8

REST , ICE ,
NSAIDS
COLCHICINE
CORTICOSTEROID

Question 9

INTERVAL THERAPY

Answer 9

NON PHARMACOLOGICAL -
LOSE WEIGHT
AVOID ALCOHOL , AVOID DIURETICS ,
PHARMACOLOGICAL =
URICOSURIC
ALLOPURINOL
FEBUXOSTAT

Question 10

SURGERY

Answer 10

CURETTAGE OF TOPHI