Gout Flashcards
1
Q
Gout in general, clinical presentation, crystal shape, etc
A
- overproduction of Uric acids (>6.8 )
- associated with hypertension and obesity
- often in 1st MTP, forefoot and ankle
- intracellular and extracelluar, neg. birefringement, Needle shaped crystals
- think yellow, Parallel, allopurinol
- tophi, renal calculi, olecranon bursitis
- mainly in men
2
Q
Pseudogout in general - clinical presentation, crystals, location
A
- Calcium pyrophosphate deposition disease
- associated with OA, hyperparathyroidism, hemohromatosis, hypophosphatemia, osteodystrophy, wilson’s
- presents mainly in knees and wrists
- intracellular and extra, pos. birefringent rhomboid shaped
- looks fluffy white on X-ray - knee, wrist, pubic symphysis
- affects men and women
3
Q
Uric Acid Metabolism
A
Purine nucleotides/sides -> hypoxanthine -> (xanthine oxidase) -> Xanthine -> (xanthine oxidase) -> uric acid
4
Q
Drugs to inhibit the Uric Acid pathway
A
- Allopurinol blocks xanthine oxidase turning hypoxanthine to xanthine
- Febuxostat - prevents xanththine oxidase from xanthine to uric acid
- pegloticase - synthestic uricase to break down uric acid
5
Q
Gout treatment - acute and chronic
A
Acute - NSAIDs, corticosteroids, Cholchicine (stop inflammasome), IL-1 antagonist (Anakinra) Chronic Gout - Uricosurics - block reuptake of uric acid (probenecid and benzbromarone) -Xanthine oxidase inhibitor - Colchicine - Pegloticase - synthetic uricase
6
Q
PseudoGout (CPPD) treatment
A
Acute -
- NSAIDs, Corticosteroids, IL-1 anatgonists? Colchicine to prevent
CHronic
- NSAIDs, Colchicine