Gout and Pseudogout Flashcards
What is Gout?
Gout is an inflammatory, metablci condition including
- Hyperuricaemia
- Deposition of Monosodium urate crystals in joints
Why do monosodium crystals form and deposit in the specific tissues that are affected by gout?
Crystals form in areas of slow blood flow
- e.g. Joints
- Kidney tubules
What are symptoms of acute gout?
Gout attach
- sudden onset (often at night)
- throbbing, crushing pain
- peak intensity after 8-12 hrs
- Red, warm, tender joint
- Most commonly 1st MTS
What are clinical signs on examination of acute gout?
- Hot, red tender joint
- Fever might be present
- Typhi (more indicator of chronic)
What are risk factors for the development of gout?
Most: Hyperuricaemia
- age
- male gender
- menopausal status in women
- renal disease
- obesity
- metabolic syndrome
- dyslipidaemia
- and use of certain drugs (for example diuretics),
- trauma,
- and genetic factors.
Which conditions are known to create a secondary hyperuricaemia?
Might therefore contribute to the formation of gout
hypertension
hyperparathyroidism
Down’s syndrome
lead nephropathy
sarcoidosis
medication
chronic renal disease
volume depletion
glycogen storage diseases
other
What is the prevalence of gout?
most common inflammatory arthritis worldwide
- men, older age
- about 2.5% of population
What would be an appropriate investigation in a person with gout or pseudogout?
- Full blood count
- Urea and electrolytes
- X-ray left foot
- Inflammatory markers (CRP)
- Liver function tests
- Needle aspiration of joint
- Negatively birefringent crystals on microscopy
- Serum urate
What would be the first line treatment for gout?
NSAIDS as analgesia
- adivce to loose weiht + alcohl intake
- Rest of affected joint
In chronic gout
Allopurino = used to reduce serum uremic acid but might trigger gout attacks
What is pseudogout?
Depositions do Calcium pyrophosphate depositions in joints (rather than Monosodium urate crystals)
Which joints are typically affected in psuedogout?
Normally knees and wrists
What is the difference between gout and pseudogout?
Both involve crystal depositions but
- Gout
- monosodium urate crystals
- most commonly 1st MTP joint
- Pseudogout
- Calcium pyrophospate crystals
- knee and wrists
What are possible causes for the development of pseudogout
Number of causes
- hypothyroidism
- acromegaly
- haemochromatosis
- and hyperparathyroidism.
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What is the MOA and indication of Allopornol?
Used in the prevention of gout by reducing serum urate concentration
- Inhibits production by inhibition of Xanthine oxidase
