Osteoarthitis And Gout Flashcards

1
Q

What is the definition of Osteoarthiritis?

A

It is where all the structures of a joint have undergone pathological chages, often at the same time, resulting in joint failure.

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2
Q

What is the role of cartilage in joints?

A

Cartilage is a thin layer of tissue between 2 bones lubricated by synovial fluid to provide a frictionless surface across which bones move.

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3
Q

Name the 4 protecetive mechanism in the joint?

A

Joint capsule and ligaments, synovial fluid, ligaments with skin and tendons overlying the ligament, muscles and tendons that bridge the joint

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4
Q

What is the summarized pathophysiology of osteoarthiritis.

A

Cartilage - shows splitting and damaged cartilage exposes proteoglycans and the negative charge attracts water (swelling occurs)
Bone - osteophytes form at the margin of the joint near the area of cartilage loss. Osteophytes are an NB indicator of OA
Synovium - becomes inflamed and oedematous

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5
Q

What are some clinical presentations of OA?

A

Pain becomes more progressive, more troublesome at night, stiffness occurs. And also weakness.

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6
Q

What are some treatment plans for OA?

A

Step 1: Paracetamol
Step 2: NSAIDs - topical or oral
Step 3: Tramadol, corticosteroids injection into the joint. And Hyaluronic acid, 3 to 5 injections weekly.

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7
Q

Where is uric acid synthesized?

A

Mainly in the liver

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8
Q

What are the clinical features of gout?

A

Overproduction and underexcretion of uric acid

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9
Q

How is uric acid formed?

A

Nucleic acids–> Purines–>Hypoxanthine–>Xanthine (Xanthine oxidase) Uric acid–> renal excretion

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10
Q

What are some signs and symptoms of gout?

A

Fever, Intense pain, erythema, warmth, elevated serum uric acid

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11
Q

Why is aspirin not given in gout?

A

Because it may cause gouty arthritis.

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12
Q

What is the MOA of colchicine?

A

Antimitotic effect - stops cell division in the GI
Inhibits the release of histamine from mast cells
May alter neutrophil motility

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13
Q

What are some common adverse effects of colchicine?

A

Nausea, diarrhoea, vomiting, abdominal pain

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14
Q

List 4 drug interactions of colch?

A

NSAIDs, CYP3A4 inhibitors, Warfarin, Alcohol

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15
Q

What is the MOA of Allopurinol?

A

Its a xanthine oxidase inhibitor. It will decrease the formation of xanthine from hypoxanthine, which will decrease levels of uric acid

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16
Q

What are some contraindications and DIs of allopurinol?

A

Acute gout, pregnancy and breast feeding. Amoxicillin (skin rash)
Thiazides - increase alloxanthine concentration

17
Q

What is the MOA of probenecid?

A

Uric acid is secreted into the proximal tubules via OAT1 and 3 transporters. Once in the urine, it is actively reabsorbed via the URAT transporter. It blocks the URAT transporter and the OAT1 and 3.