Gout Pathophysiology

Question 1

What kind of crystals get deposited in the synovial fluid/tissues?

Answer 1

monosodium urate crystals

Question 2

True or false? Is there a correlation between the uric acid level and the incidence and prevalence of gout?

Answer 2

True

Question 3

What serum urate level is correlated with hyperuricemia?

Answer 3

> 6.8 mg/dL

Question 4

What is hyperuricemia?

Answer 4

The pre-clinical version of gout

Question 5

Which joint is the most common joint for gout attacks?

Answer 5

The metatarsal felangeal joint

Question 6

What are some risk factors for increasing serum urate concentration?

Answer 6

Age (peaks at 30-50 yo)
SCr/BUN
Male (3 x more than women)
BP
Body weight
Alcohol

Question 7

What percentage of US adults have hyperuricemia?

Answer 7

21%

Question 8

Which percentage of adults with hyperuricemia develop gout?

Answer 8

20% (many remain asymptomatic)

Question 9

Which percentage of adults with hyperuricemia develop gout?

Answer 9

20% (many remain asymptomatic)

Question 10

Which enzyme converts hypoxanthine to xanthine?

Answer 10

Xanthine Oxidase

Question 11

Which enzyme converts xanthine to uric acid?

Answer 11

Xanthine Oxidase

Question 12

Do humans have uricase?

Answer 12

No, only animals. We have the non functional gene

Question 13

Do humans have uricase?

Answer 13

No, only animals. We have the non functional gene

Question 14

Do humans have uricase?

Answer 14

No, only animals. We have the non functional gene

Question 15

Which enzyme converts inosinic acid to hypoxnthine?

Answer 15

purine nucleoside phosphoylase

Question 16

Increased _____ synthetase activity increases the De Novo synthesis of purines?

Answer 16

PRPP synthetase

Question 17

AMP, IMP and GMP block what?

Answer 17

de novo synthesis of purines

Question 18

PRPP gets converted to what by 10 steps?

Answer 18

IMP

Question 19

Decreased HGPRTase activity causes what?

Answer 19

increased hypoxanthine OX

De novo synthesis through increased PRPP

Question 20

Is gout a familial disease?

Answer 20

Yes

Question 21

Gout causes what kind of arthritis?

Answer 21

Acute

Question 22

What inflammatory mediators do synoviocytes release?

Answer 22

prostaglandins, lysosomal enzymes nd IL-1

Question 23

What inflammatory mediators do synoviocytes release?

Answer 23

prostaglandins, lysosomal enzymes and IL-1

Question 24

Which granulocytes appear early on in inflammation?

Answer 24

neutrophils

Question 25

What APC appears later on in gout?

Answer 25

macrophages

Question 26

What plasma urate is correlated with symptomatic hyperuricemia in males?

Answer 26

> 7.0 mg/dL

Question 27

What plasma urate is correlated with symptomatic hyperuricemia in females?

Answer 27

> 6.0 mg/dL

Question 28

What plasma urate is correlated with symptomatic hyperuricemia in females?

Answer 28

> 6.0 mg/dL

Question 29

What is the sign of acute gout?

Answer 29

Acute arthritis in the first metatarsophlangeal joint

Question 30

What is the pharmacological intervention for acute gout?

Answer 30

colchicine

Question 31

What features are associated with the intercritical phase of gout?

Answer 31

asymptomatic

Question 32

What is the treatment during the intercritical phase of gout?

Answer 32

glucocorticoids

Question 33

What are some features of chronic gout?

Answer 33

hyperuricemia
development of tophi
recurrent attacks of acute gout

Question 34

What are some pharmacological treatments of chronic gout?

Answer 34

allopurinol/febuxostat
probenecid
pegloticase

Question 35

What is the cause of primary gout?

Answer 35

over production or decreased secretion or uric acid