Gout Flashcards
What is uric acid a breakdown product of>
purine
describe purine metabolism
purine > xanthine > Urate
By which two mechansims can urate build up in the body?
Increased production
Decreased excretion
What is the most common primary reason for increased urate production?
Lesh-nyhan syndrome
What features are present in Lesch-Nyhan syndrome?
Hyperuricaemia
Neruological dysfunction
self-mutilism
What causes secondary hyperuricaemia from the increased production of urate ?
anything that increases turnover, haemolysis, psoriasis
What are the secondary causes of hyperuraemia where urate is not excreted?
CKD
Drugs - furosomide and Thiazides
What are the three manifestations of hyperuricaemia?
Gout
renal stones
Nephropathy
What joints are most commonly affected in gout?
metacarpo-pharangeal joints
What investigations would be carried out to diagnose gout?
Bloods for urate and raised CRP
Joint tap for crystals which are negitively biofringent
What drugs would be used in and acute attack of gout?
NSAIDs steroids (injection into joint and oral)
How is Chronic gout managed?
Allopurinol
What is pseudogout?
positively biofringent crystals found in OA
How does Allopurinol work?
Xanthine oxidase inhibitor
