Gout

Question 1

Where can urate crystals be deposited?

Answer 1

Joints
Kidneys
Soft tissues

Question 2

G
O
U
T

Answer 2

Great toe
One joint
Uric acid raised
Tophi

Question 3

What constitutes a high urate?

Answer 3

> 0.4 mmol/L

Question 4

Causes of primary gout

Answer 4

uricaemia inherited disorder

hypothyrodism

Question 5

causes of secondary gout

1) Over production of uric acid
2) Under excretion of uric acid

Answer 5

1) 
Psoriasis 
Polycythaemia rubra vera 
Leukaemia 
Primary hyperparathyrodism 

2) Hypertension
Renal disease
Alcohol
Diuretics

Question 6

blood tests in gout

Answer 6

urate

u&es

Question 7

Aspiration result in gout

Answer 7

needle shaped crystals

negatively birefringent

Question 8

Xrays in gouts

early

chronic stage

Answer 8

Soft tissue swelling

joint erosion and disruption

Question 9

Acute flare treatment

Answer 9

NSAIDS
Colchicine
Steroids - if renal impairment so NSAIDS and Colchicine contraindicated

Question 10

Conservative treatment for gout

Answer 10

weight loss

Question 11

Things to avoid in gout

Answer 11

Purine rich foot
Diuretics
Alcohol excess
Aspirin

Question 12

How long to wait to give Allopurinonl

Answer 12

wait till the inflammation has reduced

Question 13

Risk factors for pseudogout

Answer 13

Arthritis
DM
Hyperthyroidism
Hyperparathyroidism

Question 14

Joints affected in pseudogout

Answer 14

knees
wrists
hips

Question 15

Joint aspiration result in pseudogout

Answer 15

oval / rhomboid crystals

positively bifringent

Question 16

Pseudogout on x-ray

Answer 16

Chondrocalcinosis

Question 17

Pseudogout treatment

Answer 17

Usually self limiting
Rest
NSAIDs

Question 18

Complications in pseudogout

Answer 18

secondary osteoarthritis

Question 19

When should urate lowering therapies be offered?

Answer 19

To all those who’ve had one attack of gout

but especially to.... 
- those with >2 attacks 
→ tophi
→ renal disease
→ uric acid renal stones
→ prophylaxis if on cytotoxics or diuretics