Gout Flashcards
True or False
Gout occurs when there is underproduction or under excretion of uric acid.
False
The correct statement is…gout occurs when there is over production or under excretion of uric acid
Addison, Allison, and Annison are triplets each with a different disease type. They each brought you their medications. Which sister is at risk for gout?
Addison : Acetaminophen for her Osteroarthritis, Lisinopril for her HTN, and simvastatin for her dyslipidemia.
Allison: Methothrexate for her Rheumatoid Arthritis and hydrochlorothiazide for her HTN.
Annison: Doesnt have any diseases but she did drink alot and fucked up her liver so both her twisted sisters decided to donate her part of their liver. The doctor told her is to be on cyclosporine to prevent organ rejection.
A. Addison
B. Allison
C. Annison
D. Addison and Allison
E. Allison and Annison
F. Addison and Annison
G. All of the sister are screwed
E. Allison and Annison
Drugs that cause gout include….
Allison is taking a cytotoxic drug (methotrexate) and a diuretic
Annison is taking cyclosporing
Which of the following drug classes can cause gout?
a. calcium channel blockers
b. diuretics
C. ACE inhibitors
D. Angiotensin Receptor Blockers
B. Diuretics
Which of the following medications does not cause gout?
A. Levodopa
B. Ethambutol
C. Pyrazinamide
D. Methocarbamol
D. Methocarbamol
Select All That Apply. Which of the following drugs causes gout?
A. Acetaminophen
B. Salicylates ( <2grams/ day)
C. Nicotinic Acid
D. tramadol
B, C
True or False
Just because you have hyperuricemia means you have gout
False
Just because you have hyperuricemia doesnt mean you have gout.
Hyperuricemia in addition to different clinical manifestations means you have gout
George is a 52 yo male presenting to your pharmacy with severe pain in his wrists and right big toe. The patient has been diagnosed with acute gouty arthritis like 7 years ago but has not experienced an acute attack since his diagnosis. He has been taking simvastatin 40mg PO HS for his hyperlipidemia. What would be the best treatment option for this patient?
A. Tylenol
B. Tramadol
C. Naprosyn
D. Colchicine
C. Naprosyn
It could technically be colchicine but since he is outpatient and we want to relieve his pain give him the naproxen.
Allison, Addison, and Annison aside from being sick patients are also medical interns. They are in rounds along with you and their attending. The attending asks the question. Jantoven is a 46 yo male with acute gouty arthritis what is the first line therapy to treat his acute gouty arthritis? They each respond….
Allison: “ Ibuprofen…give it to them”
Addison: “ just give them aspirin! its a dallar at da dallar store”
Annison: “colchicine will give them diarreah…jiji”
Which Triplet is so wrong that you give this Sheldon’s face….
Addison
Avoid Aspirin because there is renal uric acid retention at low doses of <2 grams and uricosuria at higher doses >5 grams
Timmothy is a 35 yo male who has been working at long john silver’s for like 10 years now. He loves to wear chanclas all the time and taking long walks on the beach preferably without the chanclas. One day he comes into your pharmacy with chanclas and all and he states that he has an intense pain on his ankle, heel and big toe on his right foot. He also mentioned that his heel and toe are red. When the uric acid levels come in they are 9mg/dL. What do you recommend for this patient?
A. Prednisone
B. Triamcinolone
C. Colchicine
D. Feldene
D. Feldene
First lline therapy is NSAIDs
There is 2 ways to diagnose: Aspiration and Non-Aspiration. The non-aspiration includes symptoms, risk factors and uric acid levels. Remember uric acid levels should be >7mg/dL
Colchicine is associated with all of the following adverse effects except:
A. Axonal neuromyopathy
B. Consitpation
C. Hepatotocicty
D. Bone Marrow toxicity
B. Constipation
Probenecid should be avoided in patients with all of the following except:
A. Impaired renal function
B. history of uric acid kidney stones
C. hypersensitivity to probenecid
D. Current high-dose salicylate therapy
E. underexcretion of uric acid
E. underexcretion of uric acid
The preferred treatment option for a patient with acute gout polyarticular arthritis who presents 36 hours after the onset of pain is…
A. Naproxen
B. Prednisone
C. Colchicine
D. A and B would be appropriate
E. B or C would be appropriate
D. A or B would be appropriate
An acceptable treatment option for a patient with polyarticular acute gouty arthritis of 3 days duration who cannot tolerate an NSAID is
A. IV colcrys
B. Corticosteroid
C. Oral Colcrys
D. Probenecid
E. sulfinpyrazone
B. Corticosteroid
Jaime is a 37 yo female with HTN, Diabetes, and CKD who crawls into the pharmacy presenting with a fever, redness and intense pain in her big toe. What do you recommend she take?
A. Ibuprofen
B. acetaminophen
C. Colchicine
D. methotrexate
C. Colchicine
Which of the following is not an Adverse Effect of Colchicine?
A. Rhabdomyolysis
B. Alopecia
C. Bone Marrow Suppresion
D. Abdominal Pain
A. Rhabdomyolysis
