Gout & psuedogout

Question 1

What type of condition are gout and psuedogout?

Answer 1

crystal arthropathies

Question 2

what causes gout?

Answer 2

Deposition of urate crystals in a joint due to Hyperuricaemia

Question 3

what causes Hyperuricaemia?

Answer 3

build up of purines due to either over-consumption of foods high in purines (alcohol, red meat, seafood) or renal under excretion

Question 4

which joints tend to be affected by gout in order of incidence?

Answer 4

1st MTP
ankle
knee

Question 5

how does gout present?

Answer 5

acute onset of red, hot and swollen joint that is very painful

Question 6

what is the definitive investigation for gout and psuedogout?

Answer 6

synovial fluid aspiration

Question 7

what would synovial fluid aspiration show in gout?

Answer 7

needle shaped negatively bifringent crystals

Question 8

what would synovial fluid aspiration show in psuedogout?

Answer 8

envelope shaped positively bifringent crystals

Question 9

what is the difference between gout and psuedogout?

Answer 9

gout is caused by urate crystals, psuedogout is caused by calcium pyrophosphate crystals

Question 10

what is the management for gout?

Answer 10

acute = colchicine 
prophylaxis = allopurinol

Question 11

when should allopurinol be started and why?

Answer 11

2-4 weeks after acute attack ends, can make acute attacks worse

Question 12

what is the management for psuedogout?

Answer 12

NSAIDs
steroids
colchicine

Question 13

What is the classic radiological finding in psuedogout?

Answer 13

Chondrocalcinosis