Rheumatology

Question 1

Peak incidence of gout in males vs females ?what age

Answer 1

Peak onset in males is 40-50years old as serum uric acid rises post puberty. Peak onset in females is >60 years old as serum uric acid rises post menopause

Question 2

Causes of secondary uric acid underexcretion and their mechanism

Answer 2

1. Ckd
2. Diuretics - thiazide and loop
3. Low dose aspirin - promotes urate reabsorption by urat1, oat10
4. Pyrazinamide
5. Ciclosporin
6. Toxins - lead

Question 3

Causes of primary underexcretion of uric acid

Answer 3

Renal urate transporter mutations
1. ABCG2 loss of function - decreased renal and GI excretion
2. URAT1 gain of function - increased absorption.