Gout

Question 1

What is gout?

Answer 1

Acute or chronic arthritic disease of joints

Question 2

What is gout associated with?

Answer 2

High blood Uric acid and precipitation of Uric acid in synovial fluid

Question 3

Aetiology of gout?

Answer 3

Excess dietary DNA–>oxidation of purine base to excess Uric acid causing: 1-Uric acid in soft tissue joints
2-precipitation of Uric acid in joints leading to phagocytes in joints, leading to releases of mediators enzymes oxidisers causing inflammation of synovial membrane

Question 4

What can bring up gout Attacks?

Answer 4

Eating and drinking too much

Question 5

What are the risky foods?

Answer 5

Alcohol
Liver
Asparagus
Sweetbreads

Question 6

What dietary modifications are there?

Answer 6

Avoid aspirin
Less DNA foods
Less alcohol

Question 7

Pathophysiology of gout?

Answer 7

Precipitation of urate crystals cause phagocytes by neutrophils causing lysosomal damage and lysis of neutrophils and enzyme release OR activation of hagemans factor releasing lining production and complement activation causing acute inflammation

Question 8

In a chronic gout attack…

Answer 8

Over producers and under excretors, cause serum urate levels to increase causing formation of Na buirate, causing deposition of connective tissue causing either disorganisation of joint or gouty arthritis at distal joints

Question 9

How do you inhibit phagocytosis?

Answer 9

With colchicine.

Disrupting microtubles that transport phagocytotic vesicles inhibiting phagocytosis

Question 10

What does probenieid promote?

Answer 10

Uric acid excretion

Question 11

Allopurinol?

Answer 11

Reduces the rate of production