MS part 3: gout and lupus

Question 1

GOUT

Answer 1

-inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids within the body

Question 2

gout patho

Answer 2

-uric acid crystal deposits in tissue
-uric acid crystals form from the breakdown of purines
-normally, uric acid dissolves in the blood and excreted by the kidneys
-etiology: hyperuricemia
-overproduction of uric acid
-under excretion of uric acid

Question 3

gout risk factors

Answer 3

-obesity
-preexisting diseases: HTN, DM, renal disease, sickle cell anemia
-consuming alcohol
-diet rich in meat and seafood
-use of diuretics
-most common in males
-AA’s

Question 4

phase 1 of gout

Answer 4

-asymptomatic but with elevated serum uric acid levels and deposits in tissues
-crystals accumulate and tissue is damaged
-tissue damage triggers acute inflammation

Question 5

phase 2 of gout

Answer 5

-acute flares or attacks occur: hyperuricemia

Question 6

phase 3 of gout

Answer 6

-clinically inactive until the next flare
-may be months or years before the next flare. later, reoccuring attacks get closer and closer together

Question 7

phase 4 of gout

Answer 7

-chronic arthritis- joint pain and other signs present most of the time

Question 8

manifestations of gout

Answer 8

-PAIN
-burning
-redness
-swelling and warmth
-fever
-symptoms present for days to weeks
-metatarsophalangeal joint of the big toe is the presenting joint

Question 9

gout complications

Answer 9

-tophi- large hard nodules composed of uric acid crystals deposited in the soft tissues; may form below the skin around the joints; can cause local inflammatory response
-may drain chalky material
-renal calculi

Question 10

goal of gout pharm

Answer 10

-decrease symptoms of an acute attack and prevent recurrent attacks
-NSAIDS usually first line therapy

Question 11

Lupus patho

Answer 11

-B lymphocytes are hyperactive and produce autoantibodies- antinuclear antibody
-activated against DNA
-formation of: immune complexes
-can impact all major organ systems
-inflammatory response destroys tissue

Question 12

lupus: predisposing factors

Answer 12

-genetic
-females
-age 20-40
-AA’s
-environmental triggers
-allergy to antibiotics
-hormonal factors
-tobacco use

Question 13

lupus manifestations

Answer 13

-extreme fatigue- most common
-photosensitivity
-butterfly rash- “hallmark sign”
-fever
-weight changes
-unusual hair loss
-edema- legs or eyes
-CNS: HA, dizzy, seizures, stroke
-lungs- pleural effusions
-heart: myocarditis and endocarditis
-kidneys- nephritis
-blood- anemia, leukopenia, thrombocytopenia, blood clots
-joints- arthritis

Question 14

SLE: flares

Answer 14

-clinical course: exacerbations and remissions
-warning signs of flare: fatigue, pain, HA
-prevention: recognize warning signs and avoid triggers: sunlight exposure, infections, stress, abruptly stopping a medication