Gout

Question 1

What is gout?

Answer 1

meltabolic joint disease?

Question 2

what does gout manifest/

Answer 2

high levels of uric acids in blood and other body fluids

Question 3

what is gout related to?

Answer 3

purine metabolism–> hyperglycemia

Question 4

where is uric acid more soluble in gout?

Answer 4

in plasma and urine that synovial fluids

Question 5

in gout what does increase in uric acid lead to?

Answer 5

insoluble crystals deposited in connective tissue throughout body

Question 6

what does crystals in SF lead to in gout?

Answer 6

inflammation –> gouty arthritis

Question 7

who suffers from gout?

Answer 7

predominantly men ( peak age of onser 40-50 years)

Question 8

what are the risk factors of gout?

Answer 8

age
genetic predisposition
exc alc
obesity
certain drugs (thiazides) 
lead toxicity

Question 9

pathophysiology of gout

Answer 9

1. most uric acid ( byproduct of protein metabolism is eliminated from body through kidneys)
2. crystalisation in synovial tissue (why this happens is u/k)
3. leads to inflammatory response in joint leads to tissue damage

Question 10

what is proposed to be possible reason for crystalisation in synovial tissue in gout?

Answer 10

1. lower body temperatues at periphery of body
2. decreased albumin or glycosaminoglycan levels
3. changes in ion conc and pH
4. rauma that promotes crystal precipitation

Question 11

symptoms of gout

Answer 11

1. attacks occur abruptly
2. primary sympt is severe pain usually at noght
3. affected area becomes hot, red and extremely tender and slightly swollen
4. 50% of initial attacks are in metatarsophalangeal joints of big toe
5. other 50% elbow, heel, ankle, instep of foot, knee and wrist

Question 12

TM of gout

Answer 12

1. anti inflame drugs eg. NSAIDS
2. antihyperuricemic drugs (eg. allopurinol) are given to reduce serum urate concentrations
3. uricosuric drugs (eg. probenecis) to increase excretion of urate by blocking its reabsorption by kidney tubules
4. hydrocortisone may be injected to joint to relieve pain
5. ice may relieve inflammatory pain
6. low protein diet to decrease uric acid concentration