Gout Flashcards
1
Q
Define gout
A
Uric acid crystal formation due to hyperuricamia causing symptoms
2
Q
What are the risk factors for gout?
A
Male
Drugs
- diuretics, thiazides, furosemide, cytotoxic agents, furosemide, pyrazinamide
- Alcohol
Diseases
-DM, chronic renal failure, obesity, triglycerides ++, HTN, CAD
Other
-Meat/seafood
3
Q
What are the features of acute gout?
A
Monoarthritis
- 1st MTP joint*
- Knee, midtarsal, wrists, ankles, small hand joints, elbows
Very painful and rapidly accelerating
Inflammation w/ fever and malaise
4
Q
What are features of chronic gout?
A
- Tophus formation &joint destruction (soft deposits of irate in digits, helix of ears, bursar, tendon sheaths
- Cartilage destruction leads to deformities
- Renal disease - due urate deposits causing nephropathy
5
Q
What are the investigations of gout?
A
Synovial fluid analysis
- Needle crystals
- Negative birefringement
Serum urate levels increased
XRAY in recurrent
- Joint effusion
- Eccentric erosion
- Soft tissue tophi
6
Q
What is the management of gout?
A
- LIFESTYLE
- Reduce alcohol intake
- Lose weight
- Avoid food high in purines (liver, kidney, seafood, oily fish)
*MEDICAL
Acute
- NSAIDs
- Steroid injection
- Colchicine
Prophylaxis
Allopurinol (start only 2 weeks after no symptoms)
-If already on when attack then continue
-continue aspirin
