Gout + pseudogout

Question 1

Where does gout most commonly occur?

Answer 1

great toe MTP

Question 2

What is podagra?

Answer 2

foot trap’, is gout which affects the joint located between the foot and the big toe, known as the metatarsophalangeal joint.

Question 3

What are tophi?

Answer 3

urate deposits which form in joints, cartilage, and bone

Question 4

Three differentials for gout?

Answer 4

septic arthritis
pseudogout
haemarthrosis

Question 5

Two causes of gout?

Answer 5

drugs
reduced excretion (renal impairment, primary gout)
increased cell turnover
alcohol excess
purine rich foods

Question 6

Two drugs that can cause gout?

Answer 6

diuretics, NSAIDs, cytotoxics, pyrazinamide

Question 7

Two conditions that gout as a result of increased cell turnover?

Answer 7

leukaemia, lymphoma, haemolysis, tumour lysis syndrome

Question 8

Two foods rich in purine?

Answer 8

beef, pork, lamb, seafood

Question 9

Two drug treatments for gout?

Answer 9

NSIADs

Colchicine

Question 10

Name a condition in which colchicine is contraindicated

Answer 10

Renal impairment, use steroids instead

Question 11

One conservative preventative measure for gout and one medical

Answer 11

conservative- lose weight, avoid alcohol excess

Allopurinol

Question 12

Which type of crystals cause gout?

Answer 12

sodium urate crystal

Question 13

What is another name for polyarticular gout?

Answer 13

crystal arthritis

Question 14

Name two types of crystal arthritis

Answer 14

gout and CPPD- calcium pyrophosphate deposition disease

Question 15

Two unmodificable risk factors for gout?

Answer 15

age, male, race, genetic factors, impaired renal function

Question 16

What would you see in an aspirate due to gout?

Answer 16

blue pin needle crystals

Question 17

How can you differentiate CPPD/psuedogout with gout?

Answer 17

less commonly affects 1st MTP (big toe) and most commonly seen in the knee, wrist, and shoulder

Question 18

What are two differences between gout and pseudogout?

Answer 18

Gout- urate crystals+ needle shaped. Pseudogout- calcium pyrophosphate crystals + rhomboid shaped

Question 19

What is the presentation of acute CPPD?

Answer 19

acute monoarthropathy of knee, wrist, hip

Question 20

What is the presentation of chronic CPPD?

Answer 20

destructive changes like OA, can present as polyarthritis

Question 21

Name an autoimmune condition is associated with pseudogout

Answer 21

 Hypothyroidism
 Hyperparathyroidism
 Hereditary haemochromatosis
 Wilson’s disease

Question 22

Name a classic finding on xray in CPPD

Answer 22

osteophyte hook

Question 23

Name a classic finding on xray in gout

Answer 23

tophi