OnlineMedEd - Rheumatology: Monoarticuloarthropathy Flashcards
Remember: red, hot, swollen joint…. ______________.
aspirate the joint fluid
Single inflamed joints are either ________________.
septic or crystal
Analysis of joint fluid from a crystalopathy will show ________________.
crystals, fewer than 50,000 cells, and slightly cloudy but not acutely pus-filled joint fluid
Colchicine is often the first treatment for crystal flares in patients with _____________.
kidney disease (in whom NSAIDs are contraindicated)
Gout can result from two pathologic states: ___________________.
decreased elimination of uric acid or increased production of uric acid
Most people with gout are over producers.
If a person has gout due to decreased excretion of uric acid, then they should be treated with _______________.
probenecid
In patients at risk of tumor lysis syndrome, prophylaxis is done with allopurinol and ______________.
IV fluids
If someone develops tumor lysis syndrome, treat them with _______________.
rasburicase (or other agents that increase the solubility of uric acid)
Patients with gout most commonly have one of three risk factors: _________________.
chronic kidney disease, excess alcohol intake, or diuretic use
What three dietary items increase the risk of gout?
- Meat
- Alcohol
- Fructose
Typically, you should only obtain a patient’s uric acid level when ________________.
they have repeated attacks despite lifestyle modifications and you intend to place them on chronic therapy
What is the purpose of obtaining uric acid levels?
If you are putting someone on chronic therapy (e.g., allopurinol), then you need to monitor uric acid levels to assess risk. Risk of gout decreases when uric acid levels are less than 6.8.
Allopurinol can trigger acute gouty attacks. What should you do if this occurs?
Continue administration of allopurinol and treat the symptoms with the usual triplet of NSAIDs, colchicine, or steroids.
Nongonococcal infections can be seeded by two mechanisms: ________________.
direct from the nearby skin (which will be evidenced by an abscess near the swollen joint) or hematogenous spread
List three populations that are at increased risk of nongonococcal joint infections.
- IV drug abusers
- Hemodialysis patients
- Immunocompromised patients