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PSBIM: Rheumatology > Gout And Other Crystal-associated Arthropathies > Flashcards

Gout And Other Crystal-associated Arthropathies Flashcards

1
Q

Polarized light microscopy can identify most typical crystals except

A

Apatite

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2
Q

Most common early clinical manifestation of gout

A

Acute arthritis

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3
Q

Most commonly involved joint in gout

A

1st MTP joint

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4
Q

Rare type of gout unless with strong family history

A

Premenopausal gout

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5
Q

Indications for 24-hour urine collection for uric acid

A

Risk for stones
Determining if overproducing or underexcreting uric acid
Deciding appropriateness of uricosuric therapy

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6
Q

Purine overproduction

A

Urinary excretion of > 800mg uric acid per 24hours

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7
Q

Mainstay of treatment for acute gout

A

Anti-inflammatory drugs (colchicine, NSAIDs, glucocorticoids)

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8
Q

What to do when with loose stools while taking colchicine

A

Stop colchicine at once

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9
Q

Goal uric acid for gout

A

5-6 mg/dl

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10
Q

Most commonly used hypouricemic agent for gout

A

Allopurinol - best for overproducers, with urate stones, with renal disease

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11
Q

Most serious side effect of allopurinol

A 
Rash that can progress to TEN
Systemic vasculitis
Bone marrow suppression
Granulomatous hepatitis
Renal failure
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12
Q

Duration of colchicine prophylaxis and hypouricemic agent

A

Until normouricemic and with no gouty attacks for 6 months or until with tophi

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13
Q

5 conditions associated with CPPD arthritis (5H)

A 
Hyperparathyroidism
Hemochromatosis
Hypomagnesemia
Hypophosphatasia
Hereditary
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14
Q

Most frequently involved joint in CPPD disease

A

Knee

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15
Q

Presumptive diagnosis of CPPD

A

Chondrocalcinosis

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16
Q

Most common precipitant of CPPD disease

A

Trauma

17
Q

Appearance of MSU crystals in polarized light microscopy

A

Needle shaped, negative birefringence

18
Q

Appearance of CPPD crystals in polarized light microscopy

A

Rhomboid/square/rod-like, weak positive birefringence

19
Q

Appearance of calcium apatite crystals in polarized light microscopy

A

Not seen - crystals are very small and can only be seen via electron microscopy (nonbirefringent globules, stain red with alizarin red S and purple with Wright’s stain)

20
Q

Appearance of calcium oxalate crystals in polarized light microscopy

A

Bipyramidal, strong birefringence, stain with alizarin red S

21
Q

Most common sites of calcium apatite deposition

A

Bursae and tendons in and/or around knees, shoulders, hips, fingers

22
Q

Most common conditions associated with calcium apatite deposition

A

Hyperparathyroidism and hyperphosphatemia in renal failure/ESRD patients

23
Q

Most common condition associated with calcium oxalate deposition

A

ESRD patients on HD being given ascorbic acid

PSBIM: Rheumatology (2 decks)

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