Gout and Treatment

Question 1

Diagnostic criteria for gout

Answer 1

Urate crystals negatively birefringent and needle shaped

Question 2

Why males are at greater risk for gout

Answer 2

Higher serum urate, estrogen helps clear urate in the kidneys

Question 3

Hereditary causes of gout

Answer 3

PRPP synthetase variants, HGPT deficiency

Question 4

Drugs promoting hyperuricemia

Answer 4

Diuretics, organic acids, ethanol

Question 5

Risk factor for gout kidney stones

Answer 5

Increased uric acid excretion, reduced urine volume, low urine pH

Question 6

Uses of colchicine

Answer 6

Terminate/prevent acute gout attack by preventing neutrophil chemotaxis

Question 7

Adverse effect of colchicine

Answer 7

GI disturbance (diarrhea)

Question 8

Uses of allopurinol

Answer 8

Xanthine oxidase inhibitor, dissolves crystals, prevents stone formation, allopurinol for life in enzyme deficient gout

Question 9

Contraindications of allopurinol

Answer 9

Interacts with 6-MP, do not give with impaired renal function, don’t take with ampicillin, exfoliative dermatitis

Question 10

Uric acid on the kidney

Answer 10

Freely filtered at glomerulus, reabsorbed at PCT, secreted at PCT, reabsorbed again

Question 11

MOA of probenecid

Answer 11

Competes with uric acid for reabsorption

Question 12

MOA of pegloticase

Answer 12

Turns urate into allantion

Question 13

Side effects of pegloticase

Answer 13

Gout flares, Ab to PEG

Question 14

Calcium pyrophosphate appearance

Answer 14

Blue rhomboid positive birefringent

Question 15

Common location for pseudogout

Answer 15

Knee, wrist

Question 16

Pseudogout genetics

Answer 16

Idiopathic, associated with ANKH on chr 5p

Question 17

Basic calcium phosphate crystals

Answer 17

No birefringence, linked with OA