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GI/Rheumatology Module > Pathophysiology of Gout and Hyperuricemia > Flashcards

Pathophysiology of Gout and Hyperuricemia Flashcards

1
Q

What are the Purines?

A

Guanine and Adenine

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2
Q

What is the Purine Metabolism?

A

Purine –> Inosine –> Hypoxanthine –> Xanthine –> Uric Acid
catalyzed by Xanthine Oxidase

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3
Q

What is Hyperuricemia?

A

Increase urate concentrations
Plasma Urate > Saturation

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4
Q

Gout is the most common form of what?

A

Inflammatory Arthritis

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5
Q

What is Tophi?

A

Urate deposits in tissues

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6
Q

What is Urate Nephropathy?

A

Acute uric acid nephropathy, can result from tumor lysis syndrome

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7
Q

What are the clinical conditions that are associated with hyperuricemia?

A
  1. HTN
  2. Type 2 DM
  3. Hyperlipidemia
  4. CAD
  5. Obesity
  6. Metabolic Syndrome
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8
Q

What is Primary Hyperuricemia?

A
  1. Primary under excretion of uric acid
  2. Primary overproduction
    HGPRT Deficiency or PRPP Synthetase
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9
Q

What causes Secondary Hyperuricemia *underexcretion?

A
  1. Medications: diuretics, cyclosporine, salicylate
  2. Ethanol
  3. Lead
  4. Renal Insufficiency
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10
Q

What causes Secondary Hyperuricemia *overproduction?

A
  1. Diet, ethanol
  2. High cell turnover
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11
Q

What is an Acute Attack of Gout?

A
  1. Response to urate crystals
  2. Crystals are engulfed by WBC
  3. Inflammation
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12
Q

What is the most common distribution of Acute Attack of Gout?

A

1st MTP joint MOST Common
Monoarticular Typical common later

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13
Q

What is the Course of Gouty Arthritis?

A
  1. Asymptomatic Hyperuricemia
  2. Acute Attack of Gout
  3. Intercritical period
  4. Chronic tophaceous gout
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14
Q

What is used in a Gout Diagnosis?

A
  1. Gram stain and culture
  2. WBC count
  3. Crystal analysis by polarized light microscopy
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15
Q

What is a definitive finding for gout?

A

Monosodium urate crystals
Crystals in PMB support diagnosis of acute attack

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16
Q

What is CPPD?

A

Calcium Pyrophosphate Dihydrate Deposition

17
Q

What is CPPD associated with?

A

Pseudogout Acute Attacks
can be associated with accelerated osteoarthritis, CKD, and hyperparathyroidism

18
Q

What is a hallmark of CPPD and Pseudogout?

A

Chondrocalcinosis, calcium depositions in joint space

19
Q

What is a definitive diagnosis of CPPD and Pseudogout?

A

CPP Crystals in Synovial Fluid

GI/Rheumatology Module (18 decks)

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