L6 - Crystal arthropathy + RA

Question 1

Summarise pathophys of gout

Answer 1

1. Overproduction of uric acid
2. Or undersecretion of uric acid
3. elevated [uric acid]
4. urate crystal formation
5. interaction with inflammatory system
6. acute gout
   —-> 1st MTPJ, hot
   exquistely tender

Question 2

What are tophi?

Answer 2

urate crystals may deposit in soft tissues.

– such as pinna of ear

Question 3

Joint aspiration of gout would show what?

Answer 3

• negatively bifringent needle shaped crystals

G - great big toe (1st MTPJ)
O - one joint only
U - [uric acid] elevated
T - tophi

Question 4

summarise treatment of gout

Answer 4

1. Acute
   
   • –> NSAIDs
   • –> steroids
   • –> colchine
2. Preventatory measures
   —> modify risks, obesity
   alcohol and red meat

Question 5

What is psuedogout?

Answer 5

• calcium pyrophosphate crystals within joint

Question 6

What might be observed in psueodgout?

Answer 6

• positively bifringent, brick shaped

Question 7

Compare and contrast osteoarthritis and rheumatoid arthritis?

Answer 7

Osteoarthritis

• bone ends rub together
• articular cartilage

rheumatoid arthritis
- swollen, inflammation of synovial membrane

Question 8

Rheumatoid nodules signify?

Answer 8

• more severe disease

- made up of fibrinoid, monocytes and macrophages