Gout Flashcards
What is the typical history associated with gout?
Sudden onset of severe joint pain, usually at night. Commonly affects the big toe (podagra). History of high purine diet, alcohol consumption.
What are the key physical examination findings in gout?
Red, swollen, and tender joint. Tophi in chronic cases. Limited range of motion due to pain.
What investigations are necessary for diagnosing gout?
Serum uric acid levels. Synovial fluid analysis: urate crystals. Imaging: X-ray or ultrasound to detect tophi.
What are the non-pharmacological management strategies for gout?
Dietary modifications: avoid high-purine foods, alcohol. Weight loss and regular exercise. Adequate hydration.
What are the pharmacological management options for gout?
NSAIDs for acute attacks. Colchicine or corticosteroids if NSAIDs are contraindicated. Long-term management with urate-lowering therapy (allopurinol, febuxostat).
What are the red flags to look for in gout patients?
Frequent or severe attacks. Signs of joint infection: fever, severe pain, redness. Tophi causing functional impairment.
When should a patient with gout be referred to a specialist?
Refractory gout not responding to standard treatments. Complications such as chronic tophaceous gout. Need for differential diagnosis of other joint disorders.
What is one key piece of pathophysiology related to gout?
Hyperuricemia leads to the formation of monosodium urate crystals in joints. Crystals trigger inflammatory response, causing acute pain and swelling.
