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Phase 2a MSK > Gout and Pseudogout > Flashcards

Gout and Pseudogout Flashcards

1
Q

Name 2 crystal arthropathies

A

Gout and pseudo gout

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2
Q

What is the most common inflammatory arthritis in UK?

A

Gout

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3
Q

What is Gout?

A

Hyperuricemia (high uric acid in blood)
Sodium Urate crystal deposition along joints + interarticularly

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4
Q

Who is a typical Px?

A

Middle aged overweight men

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5
Q

What are the risk factors gout?

A

Purine rich food, meat, seafood, Beer, fizzy drinks
CKD + diuretics

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6
Q

What food can be anti gout?

A

dairy

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7
Q

what is the pathology of the crystals forming?

A

Purines -(Xanthine oxidase)-> Uric Acid <–> Monosodium urate (sharp crystals)

Uric acid –> Kidney excretion also

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8
Q

High uric acid/CKD =

A

impaired excretion therefore high monosodium urate

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9
Q

Symptoms of gout

A

Monoarticular; typically big toe (metatarsalphalangeal joint), sudden onset, severe, swollen red toe, can’t put weight on it (*bed sheets)

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10
Q

What is a differential diagnosis?

A

septic arthritis

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11
Q

Diagnosis of gout
Tests and results

A

Joint aspirate + polarised light microscopy
Negatively vely birefringement needle shaped crystals

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12
Q

Treatment for gout

A

Diet; decrease purines, increase dairy
NSAIDS, colchicine then consider steroid injections
Prevention (lower uric acid levels) = ALLOPURINOL

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13
Q

What is colchicine?

A

Anti inflammatory - inhibit WBC migration

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14
Q

What is the mechanism of allopurinol?

A

Xanthine oxidase inhibitor (lower uric acid)

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15
Q

What is pseudo gout?

A

Calcium pyrophosphate crystals deposit along joint capsule

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16
Q

Who is a typical Px?

A

Elderly females (70+)

17
Q

RF for pseudo gout?

A

Diabetes, Metabolic diseases, osteoarthritis

18
Q

Symptoms of Pseudo gout?

A

often polyarthritis with knee commonly involved
swollen hot red

19
Q

Diagnosis of pseudo gout

A

Joint aspirate + polarised light microscopy
Positive vely birefringement, Rhomboid shaped crystals

20
Q

Treatment for pseudo gout

A

Only acute management
NSAIDS, colchicine then steroid injection
no prevention drug here

21
Q

Gout vs pseudo gout
Crystals made of?
Shape of needles?
Birefringement?
Affects what kind of joints?

A

Monosodium urate
Yellow needle shaped crystals
negatively
Affects smaller joints (big toe)

Calcium pyrophosphate
blue rhomboid shaped
positive
Affects larger joints (knee)

Phase 2a MSK (10 decks)

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