Musculoskeletal Gout / Lupus (Exam 4)

Question 1

Gout

Answer 1

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

The disease of KINGS (From eating wealthy people food)

Question 2

Gout: Pathogenesis

Answer 2

Uric acid Crystal deposits in tissues

Crystals form from breakdown of purines. Body makes purine

Question 3

Purine Food (Gout)

Answer 3

Organ meats, shellfish, anchovies, herring, asparagus, mushrooms

Question 4

Normal Uric acid is

Answer 4

Dissolved in the blood and excreted by the kidneys

Question 5

Hyperuricemia is caused by

Answer 5

Overproduction of uric acid and under secretion of uric acid

Question 6

Gout Risk Factors

Answer 6

Obesity
African American
Men
Pre Existing diseases
Consuming ETOH
Diet rich in meat and seafood
Use of diuretics

Question 7

Phase of Gout

Phase: 1
Phase: 2
Phase: 3
Phase: 4

Answer 7

1: Asymptomatic but with elevated serum uric acid levels and deposits in tissues
-Crystals accumulate and tissues is damaged
-Acute inflammation occurs

2: Acute flares or attacks – Hyperuricemia

3: Clinically inactive until next flare – continued hyperuricemia
-May be months or years before the next flare. Later, recurring attacks get closer and closer together

4: Chronic arthritis- joint pain and symptoms present most of the time

Question 8

Gout: Clinical Manifestations

Answer 8

PAIN
-May be mild or excruciating
-Usually the lower extremities (Feet and big toe)

Burning
Redness
Swelling and warmth
Fever
Symptoms present for days to weeks

Question 9

Gout Complications

Answer 9

Tophi: Large HARD nodules composed of uric acid crystals deposited in soft tissues
-May form below the skin around the joints
-Can cause a local inflammatory response
-May drain CHALKY MATERIAL

Renal Calculi (Kidney Stones)

Question 10

Gout Pharm Goal

Answer 10

Decrease symptoms of an acute attack and prevent recurrent attacks

Question 11

First line treatment for GOUT

Answer 11

NSAIDS
allopurinol
colchicine
probenecid

Question 12

Systemic Lupus Erythematosus

Answer 12

SLE Lupus

Question 13

Lupus Pathogenesis

Answer 13

Autoimmune condition

B-lymphocytes are hyperactive and produce autoantibodies.

Autoanitbodies attack our DNA on any or all of our major organ systems

The inflammatory response destroys tissues

Question 14

Most common antibody in lupus

Answer 14

ANA: Antinuclear Antibody

Question 15

Most common area of SLE Immune complexes

Answer 15

Kidney

Question 16

Lupus Risk Factors

Answer 16

Genetics

Females

20-40

Blacks

Environmental Triggers

Allergy to antibiotics

Hormonal Factors (Oral birth control)

Smoking

Question 17

Lupus Manifestations

Answer 17

EXTREME fatigue

Photosensitivity

Butterfly Rash

Unusual Hair Loss

Edema

Raynaud’s

Question 18

Lupus: more clinical manifestations

Answer 18

Brain (Seizures HA Stoke)

Lungs (Pleuritis / Effusions)

Heart (Myocarditis / Endocarditis)

Kidneys (Nephritis)

Blood vessels (Vasculitis)

Blood (Anemia)

Joint (Arthtitis)

(all infections or inflammation) (LUPUS infection all organ systems)

Question 19

SLE: Clinical Course

Answer 19

Exacerbations and remissions.

A flare is an acute exacerbation of symptoms

Question 20

Warning signs of a lupus flare

Answer 20

Fatigue
Pain
Headache

Question 21

SLE Flares: Prevention

Answer 21

Recognize warning signs and avoid triggers

Question 22

SLE: Triggers

Answer 22

Sunlight exposure

Infections

Abruptly stopping medications

Stress

Question 23

SLE: Pharmacotherapy

Answer 23

Depends on what is involved

Question 24

SLE Pharm: H/A - msk - pleuritis - pericarditis

Answer 24

NSAIDS

Question 25

SLE Pharm: Kidney dz and CNS

Answer 25

High dose corticosteroids

Question 26

SLE Pharm: Arthritis

Answer 26

Low dose corticosteroids

Question 27

SLE Pharm: Severe Organ Involvement

Answer 27

Methotrexate

(immunosuppressive)