Gout Flashcards
What is the pathology of gout?
Hyperuricaemia leading to deposition of monosodium urate crystals in articular spaces
What are the two modes that hyperuricaemia is caused?
Overproduction
Under excretion
What pathologies cause over production of uric acid?
Malignancy
Severe psoriasis
What drugs cause hyperuricaemia?
Cytotoxic
Alcohol
What genetic syndrome causes hyperuricaemia and what is it’s mechanism?
HGPRT deficiency (lesch-nyan syndrome) Recycles purines
What are the causes of under excretion of uric acid?
Renal failure
Renal drugs
Lead poisoning
Hypothyroidism
What doesn’t always mean gout?
Elevated uric acid
What is found on examination of the feet in gout?
Tophi of the 1st MTP joint
What can be done to the tophi diagnostically?
Aspirate
Polarised light microscopy
What is shown by gout on polarised microscopy?
Negatively birefringent spike like crystals
What imaging can be done?
X ray
What does gout x ray show?
Periarticular erosion
What is the acute management of gout?
NSAIDs
Colchicine
What can be used prophylactically to treat gout?
Allopurinol
- Treats hyperuricaemia
What is allopurinal?
Xanthine oxidase inhibitor (involved in metabolism of uric acid)
