Gout Flashcards
What is gout?
Crystal arthropathy associated with chronically high blood uric acid levels.
What causes the hot, swollen, and painful joint in gout?
Urate crystals depositing in the joint.
What are gouty tophi and what do they commonly affect?
Subcutaneous deposits of uric acid typically affecting small joints and connective tissues of hands, elbows, and ears.
Which joint in the hand is most commonly affected in gout?
Distal interphalangeal joints
What is the emergency differential of gout?
Septic arthritis
What is this a presentation of:
Obese male, single swollen, painful joint. High alcohol and red meat intake, existing cardiovascular disease?
Gout
Which joints are most commonly affected in gout?
- Base of big toe (metatarsophalangeal joint)
- Wrists
- Base of thumb (carpometacarpal joint)
- Knee and ankle
What investigations are ordered in suspected gout?
- Joint aspiration
- Joint x-ray
- Uric acid blood test
- Exclude sepsis
What does this joint aspiration finding indicate?
- No bacterial growth
- Needle shaped crystals
- Negative birefringent of polarised light
- Monosodium urate crystals
Gout
What does this joint x-ray finding indicate?
- Joint space maintained
- Lytic lesions in bone
- Punched-out lesions
- Erosions with sclerotic borders and overhanging edges.
Gout
What is the pharmaceutical management of an acute flare of gout?
- NSAIDs (1st line)
- Colchicine (2nd line, patient inappropriate for NSAIDs)
- Steroids (3rd line)
What is the management for prophylaxis of gout?
- Allopurinol (xanthine oxidase inhibitor, lowers uric acid) - not to be started during acute attacks, does not need stopped when attack happens.
- Lose weight, stay hydrated, lower alcohol and purine-based food intake.
