Gout

Question 0

How is gouty arthritis different from other types of arthritis?

Answer 0

It is caused by a CHEMICAL rather than “wear n tear” or autoimmune factors.

Question 1

Define Gout…

Answer 1

Condition of abnormally high amounts of uric acid in the blood. (Hyperuricemia)

Question 2

Define gouty arthritis…

Answer 2

An inflammatory arthritis caused by the deposition of MONOSODIUM URATE (msu) crystals IN and ABOUT specific joints n tendons.

Question 3

Uric acid is NOT a metabolite.

True / False?

Answer 3

False.

It is a metabolite.
Waste product from normal metabolism of PURINE

Question 4

Why may the body be unable to eliminate uric acid?

Answer 4

A) excessive amounts of chemical
(Lots of rich food &/ alcohol)

B) kidney malfunction thus unable to filter chemical
(Chronic diuretic therapy, renal diseases etc)

Question 5

Uric acid is very soluble in cooler areas of the body.

True / False?

Answer 5

False.

It is less soluble in cooler areas of the body.

Question 6

What hypo vascular structures does the uric acid tend to collect in?

Answer 6

Tendons 
Ligaments
Cartilage (joint capsule)

Question 7

What is Tophus/Tophi?

Answer 7

Clusters of sodium URATE combined with DEAD CELLS and ENZYMES that the body has produced to isolate the crystals.

Question 8

What are punched out lesions palpated as in later stages of gouty development?

Answer 8

Subcutaneous nodules.

-sometimes misdiagnosed as rheumatoid nodules-

Question 9

What are the common palpatory areas for TOPHI?

Answer 9

Olecranon bursa
Achilles’ tendon
Forearm extensors

Question 10

How long after gout does Tophi generally appear?

Answer 10

10 years after 1st attack.

Question 11

Name 5 risk factors for gout…

Answer 11

• Diet high in purine
• obesity / sudden weight gain
• diabetes
• renal pathologies
• moderate to high alcohol intake
• heredity
• high blood pressure

Question 12

List some triggers to a gouty flare up…

Answer 12

• high purine foods
• dehydration
• surgery
• fatigue
• foot injury
• sudden illness
• certain medications
• infections, vascular occlusion, emotional stress etc

Question 13

Which joint is most commonly affected in gout?

Answer 13

1st metatarsophalangeal joint

Question 14

Onset of gout is usually slow and progressive.

True / False?

Answer 14

False.

Onset is abrupt and sever, often occurring at night.

Question 15

List the tissue manifestations of gout during acute inflammation.

Answer 15

Heat
Shiny
Swelling
Red
Purple
Tense skin
Exquisite tenderness

Question 16

The duration of gouty attacks are different from first attack and typically last longer with recurrent attacks.

True / False?

Answer 16

True.

Recurrent attacks can last for weeks whilst initial attacks can last only a few hours.

Question 17

Tachycardia, fever, chills and malaise occur in acute or chronic stage?

Answer 17

Chronic.

Question 18

Name some chronic gouty complications.

Answer 18

• High blood pressure
• atherosclerosis
• stroke
• extreme joint destruction n deformity
• renal failure
• May show constant acute gout inflammation post 10-20 years

Question 19

What is the technical name for pseudo gout?

Answer 19

Calcium pyrophosphate dihydrate (CPPD)

Question 20

Define CPPD..

Answer 20

Intermittent arthritic joint disease causing severe degenerative arthropathy on articular cartilage invasions sites.

Affects men n women equally.

Question 21

List some causes of pseudo gout.

Answer 21

• Idiopathic
• trauma
• amyloidosis
• myxedema
• hyperparathyroidism

Question 22

Define amyloidosis.

Answer 22

Metabolic disorder marked by amyloid deposition in tissues and organs.

Question 23

Define myxedema.

Answer 23

Enlargement and puffiness of face, tongue, hands and skin due to hyperthyroidism.