Gout Flashcards
gout is the deposition of what ind of crystals in the joints? when these crystals are deposited into the connective tissue, what is the disorder called?
monosodium urate; tophi
what are the two pt demographics in which gout is most common?
elderly men and post menopausal women
True or False: hypercholesterolemia is a risk factor for gout.
true – the others include obesity, HTN, renal dysfunction; alcohol excess and dehydration and drugs
which two drugs commonly taken are known to be risk factors for gout?
salicylates and diuretics
the ddx for gout includes pseudo gout - one difference is in the crystals - what are they made out of with pseudo gout?
calcium pyrophosphate dihydrate
an increase is what type of foods can lead to the development of gout?
increased intake of purine rich food
true of false: a majority of hyper-uremic patients will eventually develop gout?
false
true or false: typically multiple joints are involved in the first episode of gout.
false; it’s typically only one joint that is involved
in elderly pple with advanced disease, the fingers may be involved in early manifestations of gout - what are bouchard’s nodules? who is their parter in crime?
B - nodes on the distal joints vs. Heberden’s nodes which are nodes on the proximal joints
the first attack of gout can present as warm, red and tender - this often makes it easy to confuse with what?
cellulitis
a medical term for a tiny collection of immune cells known as macrophages.
granuloma - form when the immune system attempts to wall off substances that it perceives as foreign but is unable to eliminate.
what is chronic tophaceous gout often confused with?
RA
true or false: uric acid levels may be low or normal during an acute attack of gout
True
+ or - birefringement fo gout?
negative
what is the DOC for treatment of acute phase of gout? what is recommended as a safer CVS profile?
indomethacin; naproxen
what is the recommended dosage for indomethacin?
25-50 mg POx3/day
what is the gout drug that must be tapered in use and is safe for patients with peptic ulcer disease?
colchicine
what is the recommended dosage for colchicine?
.6 mg PO every 8 hours
what is the recommended dosage for prednisone for gout patients?
26-50 mg PO
what is the drug used to treat gout in patients who are under-excreters? what class of gout drug is it?
probenecid (uricosuric agent)
what is the one caveat patients must adhere to when taking the medication probenecid?
must maintain urine volume by ingesting 1500 ml of water daily
what is the xanthine oxidase inhibitor that is used to treat gout?
allopurinol
what type of patients is the drug allopurinol best to treat?
overproducers of uric acid
what is the recommended dose of allopurinol?
100 to 300 mg PO
a rare, life-threatening skin condition that is usually caused by a reaction to drugs. The top layer of skin (the epidermis) detaches from the lower layers of the skin (the dermis) all over the body.
TEN (toxic epidermal necrolysis) - associated with allopurinol toxicity
which anti HTN med is contraindicated with allopurinol? why?
thiazides b/c they lead to hyperuricemia (b/c they compete for the same secretion transporter on uric acid) and also contribute to allopurinol toxicity.
