Gout Flashcards

1
Q

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?

A

monosodium urate; tophi

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2
Q

what are the two pt demographics in which gout is most common?

A

elderly men and post menopausal women

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3
Q

True or False: hypercholesterolemia is a risk factor for gout.

A

true – the others include obesity, HTN, renal dysfunction; alcohol excess and dehydration and drugs

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4
Q

which two drugs commonly taken are known to be risk factors for gout?

A

salicylates and diuretics

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5
Q

the ddx for gout includes pseudo gout - one difference is in the crystals - what are they made out of with pseudo gout?

A

calcium pyrophosphate dihydrate

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6
Q

an increase is what type of foods can lead to the development of gout?

A

increased intake of purine rich food

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7
Q

true of false: a majority of hyper-uremic patients will eventually develop gout?

A

false

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8
Q

true or false: typically multiple joints are involved in the first episode of gout.

A

false; it’s typically only one joint that is involved

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9
Q

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?

A

B - nodes on the distal joints vs. Heberden’s nodes which are nodes on the proximal joints

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10
Q

the first attack of gout can present as warm, red and tender - this often makes it easy to confuse with what?

A

cellulitis

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11
Q

a medical term for a tiny collection of immune cells known as macrophages.

A

granuloma - form when the immune system attempts to wall off substances that it perceives as foreign but is unable to eliminate.

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12
Q

what is chronic tophaceous gout often confused with?

A

RA

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13
Q

true or false: uric acid levels may be low or normal during an acute attack of gout

A

True

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14
Q

+ or - birefringement fo gout?

A

negative

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15
Q

what is the DOC for treatment of acute phase of gout? what is recommended as a safer CVS profile?

A

indomethacin; naproxen

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16
Q

what is the recommended dosage for indomethacin?

A

25-50 mg POx3/day

17
Q

what is the gout drug that must be tapered in use and is safe for patients with peptic ulcer disease?

A

colchicine

18
Q

what is the recommended dosage for colchicine?

A

.6 mg PO every 8 hours

19
Q

what is the recommended dosage for prednisone for gout patients?

A

26-50 mg PO

20
Q

what is the drug used to treat gout in patients who are under-excreters? what class of gout drug is it?

A

probenecid (uricosuric agent)

21
Q

what is the one caveat patients must adhere to when taking the medication probenecid?

A

must maintain urine volume by ingesting 1500 ml of water daily

22
Q

what is the xanthine oxidase inhibitor that is used to treat gout?

A

allopurinol

23
Q

what type of patients is the drug allopurinol best to treat?

A

overproducers of uric acid

24
Q

what is the recommended dose of allopurinol?

A

100 to 300 mg PO

25
Q

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.

A

TEN (toxic epidermal necrolysis) - associated with allopurinol toxicity

26
Q

which anti HTN med is contraindicated with allopurinol? why?

A

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.