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
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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
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3
Q

Uric Acid Metabolism

A

Purine nucleotides/sides -> hypoxanthine -> (xanthine oxidase) -> Xanthine -> (xanthine oxidase) -> uric acid

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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
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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
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6
Q

PseudoGout (CPPD) treatment

A

Acute -
- NSAIDs, Corticosteroids, IL-1 anatgonists? Colchicine to prevent

CHronic
- NSAIDs, Colchicine

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