Gout

Question 1

Hyperuricemia caused by

Answer 1

Von Gierke’s disease
Thiazide diuretics

90% due to underexcretion, 10% overproduction

Question 2

Symptoms

Answer 2

Asymmetric joint

Classic: painful MTP of the big toe

Question 3

Acute attack

Answer 3

After a large meal or alcohol consumption,

as alcohol metabolites compete for the same site in kidney

Question 4

Tx:

Answer 4

Acute: NSAIDS and glucocorticoid

Chronic: allopurinol febuxostat.

Question 5

Pseudogout

Answer 5

Ca2+ pyrophosphate crystals in the joint space
Basophilic rhomboid crystals weakly positively birefingent

Affects large joint (knee), >50 yrs of men and women
Tx: NSAID for acute, and steroid

Gout: yellow when parallel
Pseudogout: blue when parallel