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Kumar Valori > Reumatologie - Artrite microcristaline > Flashcards

Reumatologie - Artrite microcristaline Flashcards

1
Q

Artrite microcristaline - Guta + hiperuricemie - prevalenta Marea Britanie

A

2,5%

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2
Q

Artrite microcristaline - Guta + hiperuricemie - prevalenta SUA

A

3,9%

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3
Q

Artrite microcristaline - Guta + hiperuricemie - grupuri etnice cu frecventa mai mare a hiperuricemiei

A

populatia Maori

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4
Q

Artrite microcristaline - Guta + hiperuricemie - raportul sexelor

A

M:F = 5:1

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5
Q

Artrite microcristaline - Guta + hiperuricemie - procent idiopatice

A

85-90%

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6
Q

Artrite microcristaline - Guta + hiperuricemie - prag AUS in definitia hiperuricemiei patologice

A

408 micromol/l (6,86 mg%)

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7
Q

Artrite microcristaline - Guta + hiperuricemie - prag AUS pentru formarea cristalelor de urat monosodic in articulatiile periferice la 35 de grade Celsius

A

360 micromol/l (6,05 mg%)

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8
Q

Artrite microcristaline - Guta + hiperuricemie - prag AUS pentru formarea cristalelor de urat monosodic in articulatiile periferice la 30 de grade Celsius

A

300 micromol/l (5,04 mg%)

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9
Q

Artrite microcristaline - Guta + hiperuricemie - in ce procent este realizata eliminarea uratului de catre rinichi, respectiv intestin

A

rinichi - 66%
intestin - 33%

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10
Q

Artrite microcristaline - Guta + hiperuricemie - parcursul renal al uratului - procent filtrare, reabsorbtie, secretie, rezultat net excretie

A

filtrare - 100%
reabsorbtie - 98% -> restant 2%
secretie activa - 50%
reabsorbtie pre-secretorie (?) - 40-45%
rezultat net excretie in circumstante normale - aprox. 5-10% din cantitatea filtrata glomerular

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11
Q

Artrite microcristaline - Guta + hiperuricemie - excretie renala - molecule de reabsorbtie schimbatoare de anioni-urat

A

URAT1/SLC22A12
OAT4/SLC22A11
OAT10/SLC22A3

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12
Q

Artrite microcristaline - Guta + hiperuricemie - excretie renala - transportorul de reabsorbtie al uratului

A

GLUT9/SLC2A9

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13
Q

Artrite microcristaline - Guta + hiperuricemie - excretie renala - transportoare de anioni secretori

A

OAT1, OAT2, OAT3

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14
Q

Artrite microcristaline - Guta + hiperuricemie - excretie renala - proteine transportoare de fosfat de sodiu

A

NPT1/SLC17A1
NPT4/SLC17A3

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15
Q

Artrite microcristaline - Guta + hiperuricemie - excretie renala - pompa secretorie cu motor ATP

A

MRP4/SLC17A3

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16
Q

Artrite microcristaline - Guta + hiperuricemie - excretie intestinala - transportor secretor prezent smenificativ in intestine

A

ABCG2

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17
Q

Artrite microcristaline - Guta + hiperuricemie - GWAS - loci predominanti care codifica transportatori de urat

A

in primul rand:
- GLUT9/SLC2A9
- ABCG2
apoi gene care codifica:
- URAT1/SLC22A12
- OAT4/SLC22A11
- NPT1/SLC17A1
- NPT4/SLC17A3

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18
Q

Artrite microcristaline - Guta + hiperuricemie - cauze hiperuricemie - afectare excretie acid uric

A

HTA
BRC - guta clinic manifesta rar
hiperparatiroidism primar
hipotiroidism
crestere productie acid lactic - consum alcool, infometare, excercitii fizice
terapie medicamentoasa - diuretice tiazidice, aspirina in doze mici
saturnism
deficit glucozo-6-fosfataza - interfera cu excretia renala

19
Q

Artrite microcristaline - Guta + hiperuricemie - cauze hiperuricemie - crestere productie acid uric - crestere sinteza purine de novo

A

sindrom Lesch-Nyhan - deficit de HGPRT - X-linkat
deficit Glc-6-fosfataza - boala de depozitare glicogen tip 1
hiperactivitate fosforibozil-pirofosfat sintaza

20
Q

Artrite microcristaline - Guta + hiperuricemie - cauze hiperuricemie - metabolism crescut purine

A

boli mieloproliferative - ex: policitemia vera
boli limfoproliferative - ex: leucemie
alte boli - ex: carcinoame, psoriazis sever

21
Q

Artrite microcristaline - Guta + hiperuricemie - ce inflamazom este activat?

22
Q

Artrite microcristaline - Guta + hiperuricemie - ce caspaza recruteaza inflamazomul NLRP3?

23
Q

Artrite microcristaline - Guta + hiperuricemie - ce citokina mediaza afluxul de PMN?

24
Q

Artrite microcristaline - Guta + hiperuricemie - in cat timp apare al doilea atac de guta?

A

urmatorii 2 ani

25
Artrite microcristaline - Guta + hiperuricemie - in ce procent de cazuri este afectata alta articulatie decat MTF1 in atacurile de guta?
25%
26
Artrite microcristaline - Guta + hiperuricemie - cat timp dureaza un atac netratat?
aprox. 7 zile
27
Artrite microcristaline - Guta + hiperuricemie - ce valori are AUS de obicei la investigatii in cazul unui atac?
de obicei crescut - > 600 micromol/l (10,09 mg%) - rar la valori AUS in jum. inf. a intervalului normal sub punctul de saturatie 360 micromol/l (6,05 mg%)
28
Artrite microcristaline - Guta + hiperuricemie - doze naproxen
750 mg imediat, apoi 500 mg la 8-12 h
29
Artrite microcristaline - Guta + hiperuricemie - doze diclofenac
75-100 mg imediat, apoi 50 mg la 6-8 h
30
Artrite microcristaline - Guta + hiperuricemie - dupa cat timp de la prima doza de AINS se incepe tratament cu dozele reduse si pentru cat timp?
dupa 24-48 h, timp de 1 saptamana
31
Artrite microcristaline - Guta + hiperuricemie - care e doza de colchicina care e de obicei suficienta pentru terminarea atacului fara efecte adverse?
500 microg 2-3x/zi
32
Artrite microcristaline - Guta + hiperuricemie - care sunt alimentele bogate in purine?
carne rosie, crustacee, organe, spanac
33
Artrite microcristaline - Guta + hiperuricemie - cu ce procent pot reduce AUS modificarile dietetice?
15%
34
Artrite microcristaline - Guta + hiperuricemie - care este tinta tratamentului pentru AUS in cazul in care guta nu e severa?
< 360 micromol/l (6,05 mg%)
35
Artrite microcristaline - Guta + hiperuricemie - care este tinta AUS in cazul in care guta este severa (atacuri frecvente, tofi)?
< 300 micromol/l (5,04 mg%)
36
Artrite microcristaline - Guta + hiperuricemie - alopurinol - reactii adverse
frecvente: - eruptii cutanate - intoleranta GI rare: - reactie de hipersensibilitate - supresie maduva osoasa
37
Artrite microcristaline - Guta + hiperuricemie - alopurinol - doze in IR
50-100 mg
38
Artrite microcristaline - Guta + hiperuricemie - alopurinol - pe ce perioada de la atac nu trebuie administrat
prima luna
39
Artrite microcristaline - Guta + hiperuricemie - alopurinol - cu cat timp inainte si cat timp dupa trebuie administrat pe fondul tratamentului cu AINS/colchicina
primele 2-4 saptamani inainte 4 saptamani dupa inceperea alopurinolului
40
Artrite microcristaline - Guta + hiperuricemie - alopurinol - la cat timp se creste doza si pana cand?
la fiecare cateva saptamani pana cand AUS < 360 micromol/l (6,05 mg%)
41
Artrite microcristaline - Guta + hiperuricemie - febuxostat - doze
80-120 mg/zi
42
Artrite microcristaline - Guta + hiperuricemie - benzbromarona - asupra carui transportor actioneaza?
URAT1/SLC22A12
43
Artrite microcristaline - Guta + hiperuricemie - lesinurad - ce transportor inhiba?
URAT1/SLC22A12
44

Kumar Valori (5 decks)

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