Purine And Uric Acid Metabolism Flashcards
What are the normal ranges for uric acid in males and females
Males- 200-430 umol/l
Females- 140-360 umol/l
What is gout
Accumulation of uric acid crystals in the joints
What causes the symptoms of gout
The crystals that deposit in the joint cause inflammation which causes the symptoms of swelling, pain and redness
Where is uric acid found
In the bloodstream
Is uric acid soluble
It is poorly soluble in the plasma
The lower the pH the less soluble it becomes
Where does uric acid come from
Dissolved in the blood stream from the metabolism of purines
What joint is the most commonly effected by gout
The joint in the great toe
What are examples of purines
Adenine
Guanine
Hypoxanthine
Xathine
Where can you get purines from
Diet
Breakdown of nucleotides from tissues
Synthesised in the body
How does uric acid leave the body
It can be excreted in urine from the kidneys and it can be broken down in the gut
Where can dietary purines come from
Meat
Offal - heart, liver, kidney
Seafood - muscles
Fish - herring and sardines
Oatmeal
Soya
Yeast extract
Fructose - in soft drinks
What are the risk factors of gout
Obesity
Raised triglycerides
Raised blood pressure
Coronary heart disease
Diabetes
What is the initial management for gout
Rest
Ice pack
Elevate the affected joint
Take anti-inflammatory medication
What advice could you give to reduce the risk of gout
Reduce alcohol
Avoid purine rich foods
Loose weight
Keep hydrated
Switch a blood pressure medication if needed
How is uric acid formed
Purines get converted by xanthine oxidase to xanthine and then xanthine gets converted by xanthine oxide to produce uric acid
What can be the complications of gout
Damage to the joint causing secondary arthritis
Secondary infections
Nerve damage
Kidney stones
Uric acid crystals depositing into the soft tissues
Causes of increased turnover of uric acid
Rapidly growing malignant tissue
Increased tissue breakdown
Psoriasis
What is uric acid converted into by rasburicase
Allantoin
What is lesch-Nyhan syndrome
Rare inherited disease which is x-linked so only affects boys
What are purines important for
Building blocks of DNA and RNA
What enzyme converts purines back to precursors
Enzyme HPRT
