Gouty arthritis Quiz 3 Flashcards
The clinical presentation of acute gouty arthritis affecting the base of the great toe includes:
A. slow onset of discomfort over many days.
B. greatest swelling and pain along the median aspect of the joint.
C. improvement of symptoms with joint rest.
D. fever.
The use of all of the following medications can trigger gout except:
A. aspirin.
B. statins.
C. diuretics.
D. niacin.
The most common locations for tophi include all of the following except:
A. the auricles.
B. the elbows.
C. the extensors surfaces of the hands.
D. the shoulders.
Risk factors for acute gouty arthritis include:
A. obesity.
B. female gender.
C. rheumatoid arthritis.
D. joint trauma.
Tophi are best described as:
A. ulcerations originating on swollen joints.
B. swollen lymph nodes.
C. abscesses with one or more openings draining pus onto the skin.
D. nontender, firm nodules located in soft tissue.
Gout is a
inflammatory arthritis caused by deposition of monosodium urate (MSU) crystals in joints
Gout risk factors
most common cause of inflammatory arthritis in men >40
• ETOH
• High levels of meat and seafood consumption
obesity
diuretics
HLD
DM
Gout cause by
decreased excretion (90%) or increased production of uric acid.
overproduction of with
leukemia, multiple myeloma, hemolytic anemia
disseminated carcinoma
under excretion
CRI,
lead poisoning,
acidosis,
drug ingestion(nicotinic,levadopa,diuretics,ASA,pyrazinamide, ethambutol)
Classic gout s/s
pain & erythema great toe (Podagra)
when would the first attack of gout happen
night/early am
Physical findings with gout
Redness, increased warmth, tenderness, effusion, limited ROM of joint • nonpainful tophi • Joint stiffness of chronic gout possible low grade fever or leukocytosis
Diagnostic test for gout
Uric acid serum > 7mg/dl but at time of attack 20-‐30% are wnl
24 hr urine > than 900mg uric acid
joint aspiration + for uric crystals
Gold standard for diagnosis of gout
Joint aspiration, for urate crystals
