Purine And Uric Acid Metabolism Flashcards

1
Q

What are the normal ranges for uric acid in males and females

A

Males- 200-430 umol/l
Females- 140-360 umol/l

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2
Q

What is gout

A

Accumulation of uric acid crystals in the joints

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3
Q

What causes the symptoms of gout

A

The crystals that deposit in the joint cause inflammation which causes the symptoms of swelling, pain and redness

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4
Q

Where is uric acid found

A

In the bloodstream

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5
Q

Is uric acid soluble

A

It is poorly soluble in the plasma
The lower the pH the less soluble it becomes

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6
Q

Where does uric acid come from

A

Dissolved in the blood stream from the metabolism of purines

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7
Q

What joint is the most commonly effected by gout

A

The joint in the great toe

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8
Q

What are examples of purines

A

Adenine
Guanine
Hypoxanthine
Xathine

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9
Q

Where can you get purines from

A

Diet
Breakdown of nucleotides from tissues
Synthesised in the body

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10
Q

How does uric acid leave the body

A

It can be excreted in urine from the kidneys and it can be broken down in the gut

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11
Q

Where can dietary purines come from

A

Meat
Offal - heart, liver, kidney
Seafood - muscles
Fish - herring and sardines
Oatmeal
Soya
Yeast extract
Fructose - in soft drinks

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12
Q

What are the risk factors of gout

A

Obesity
Raised triglycerides
Raised blood pressure
Coronary heart disease
Diabetes

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13
Q

What is the initial management for gout

A

Rest
Ice pack
Elevate the affected joint
Take anti-inflammatory medication

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14
Q

What advice could you give to reduce the risk of gout

A

Reduce alcohol
Avoid purine rich foods
Loose weight
Keep hydrated
Switch a blood pressure medication if needed

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15
Q

How is uric acid formed

A

Purines get converted by xanthine oxidase to xanthine and then xanthine gets converted by xanthine oxide to produce uric acid

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16
Q

What can be the complications of gout

A

Damage to the joint causing secondary arthritis
Secondary infections
Nerve damage
Kidney stones
Uric acid crystals depositing into the soft tissues

17
Q

Causes of increased turnover of uric acid

A

Rapidly growing malignant tissue
Increased tissue breakdown
Psoriasis

18
Q

What is uric acid converted into by rasburicase

A

Allantoin

19
Q

What is lesch-Nyhan syndrome

A

Rare inherited disease which is x-linked so only affects boys

20
Q

What are purines important for

A

Building blocks of DNA and RNA

21
Q

What enzyme converts purines back to precursors

A

Enzyme HPRT