Rheumoatology

Question 1

Indications for Urate Lowering therapy in Gout

Answer 1

1. 2+ attacks in 1 year
2. 1+ attack with CKD stage 2 or greater
3. 1+ attack with uric acid nephrolithasis
4. Tophi on Imaging or visible

Question 2

Indications for discontinuation of prophylaxis

Answer 2

1. 3m after goal Urate reached (5 if tophi, 6 if no tophi)

2. 6m after goal urate if tophi

Question 3

Disseminated Gonococcal Infection

• sx
• dx

Answer 3

Sx:

• poly articular arthritis
• Rash- vesticulopustular or hemorrhagic macular
• Tenosynovitis (achilles, wrist)

Dx:

• Cervical, rectal, pharynx cultures
• Often synovial fluid negative unless pustular arthritis
• NAAT