gout

Question 1

pattern of presentation of gout ?

Answer 1

male / old / with metabolic syndrom
unilateral monoarthritis (metatarsophalangeal joint) attack
developed within one day
painful swelling

Hx of previous attack

Question 2

definitive diagnoses for gout and finding ?

Answer 2

arthrocentesis :
highe WBC
urate crystals
( needle shape - negative birefringence )

Question 3

what is your expectation for serum uric acid ?

Answer 3

during attack could be low normal or high ,
test more accurate after 2 week from attack

Question 4

how to diagnose gout ?

Answer 4

((( clinically )))
unless septic arthritis suspected
or diagnosis uncertain

Question 5

witch imaging modality assisted in diagnosis of gout ?

Answer 5

US and dual energy CT
while xray an CT show structural damage

Question 6

fiers line tretment of acute flare in gout ?

Answer 6

NSAIDs

Question 7

non pharmacological treatment for gout?

Answer 7

DASH diet

life style ( low fat - low purine diet - Wt reduction - exercise - avoid alcohol )

use ice during attack improved gout

Question 8

pharmacological Rx for gout ?

Answer 8

NSAID
corticosteroid
colchicine

Question 9

dosing of colchicine and adviser effect?

Answer 9

1.2 mg followed by 0.6 mg after one hour (maximum dose 1.8 mg )

GIT affected mainly diarrhea

Question 10

indication for prophylaxis in gout ?

Answer 10

=>2 attack / year
joint damage or tophus
chronic kidney diseas or urolithiasis

Question 11

first line medication used as prophylactic of gout ? dose ?

Answer 11

allopurinol
100 mg starting dose
+100 mg / week add
maximum dose 800 mg /day