Gout

Question 1

List 3 features of acute gout flares

Answer 1

Sudden 1-3 hot joints, redness and warmth of joints, severe painful big toe, shiny skin overlying the big toe/knee

Question 2

List 5 medications that trigger gout attack

Answer 2

1. Diuretics including Hydrochlorothiazide and furosemide
2. Aspirin
3. TB meds including pyrazinamide and Ethambutol

Question 3

What is the treatment for acute gout attacks?

Answer 3

Ibuprofen

Question 4

Contraindications of NSAIDs[5]

Answer 4

1. CVS: Hypertension and heart failure
2. Resp: Asthma
3. GIT: Peptic Ulcer disease
4. Kidney: Chronic kidney disease

Question 5

Indications for allopurinol[5]

Answer 5

1. Serum urate>0.5
2. Frequent acute attacks
   :at least 2 times per year
3. Chronic tophaceous gout
4. Complications: Kidney stones and kidney disease

Question 6

Who needs lower doses of allopurinol?

Answer 6

Elderly or people with eGFR<60

Question 7

What should be suspected if a patient with BMI<18.5 OR younger than 40 present with gout?

Answer 7

Malignancy especially myeloproliferative disorders

Question 9

What are other triggers of acute gout flares except for medications?[4]

Answer 9

1. High purine foods: meat, seafood and offal
2. Drinks: Beers, sweetened fizzy drinks and red wine
3. Fasting and dehydration

Question 10

What is the initial test for gout?

Answer 10

Joint aspiration which shows needle shaped negatively birefringence

Question 12

List 5 diseases that cause gout

Answer 12

Hypertension
Diabetes
Hypertriglyceridemia
Kidney failure
Leukemia

Question 13

Can rapid weight loss cause gout?

Answer 13

Yes

Question 14

List 2 complications of gout

Answer 14

Stones and interstitial nephritis

Question 15

Adverse effects of allopurinol

Answer 15

Nausea and vomiting and diarrhea
Rash
Kidney failure
Leukopenia and thrombocytopenia