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GEM Year 1 Part II > W137 Monoarthritis/ Gout > Flashcards

W137 Monoarthritis/ Gout Flashcards

1
Q

Symptoms of septic arthritis?

A

sudden onset, pain, swelling, erythema

pretty self explanatory really

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2
Q

Most common bacterial cause of septic arthritis?

A

Staph aureus

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3
Q

main investigations for septic arthritis?

A 
Bloods: for infection, u&es/LFTs to check for organ failure
ASPIRATE JOINT FLUID
Cultures
Urate
X-ray
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4
Q

in septic arthritis what colour joint aspiration would you see?

A

opaque = septic

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5
Q

Management of septic arthritis?

A

antibiotics if in any doubt: IV 2 weeks then 4 weeks oral.

surgery Vs drainage = similar outcome

pain relief

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6
Q

difference between acute and chronic gout?

A

Presence of tophi and joint degredation with chronic. Milder inflammation hinted at.

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7
Q

Gout symptoms?

A 
exquisite pain
swelling
erythema
tophi (chronic)
any joint
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8
Q

what crystals form in normal gout?

A

monosodium urate monohydrate crystals

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9
Q

What are the two general causes of gout? (Malfunctions in body)

A
  1. overproduction of urate

2. underexcretion of urate

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10
Q

Investigation for gout?

A

Rule out septic arthritis.
Aspirate fluid!
Bloods
Urinalysis (blood and protein)

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11
Q

In gout what will joint aspiration show?

A

Urate crystals which show negative birefringent under polarised light.

Won’t be cloudy (that indicates septic arthritis)

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12
Q

What bloods do you look at in gout?

A 
urate
u and e's
creatinine
blood sugar
LFTs

ie. metabolism and excretion

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13
Q

First line, conservative management of gout?

A

lifestyle modifications to correct hyperuricemia

avoid: high purine diet, alcohol, obesity, certain meds (diuretics)

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14
Q

When do you start urate lowering therapy (ULT) in gout?

A

after second attack within a year

and/or

renal impairment/ urate stones/ tophi/ tissue damage

(basically more than once or with complications)

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15
Q

what are the two types of Urate Lowering Therapy (broadly speaking)?

A
  1. xanthine oxidase inhibitors- reduce PRODUCTION of uric acid
  2. uricosuric agents- increase EXCRETION of uric acid
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16
Q

What is a drug that reduces PRODUCTION of uric acid (gout)?

A

Allopurinol- a xanthine oxidase inhibitor

17
Q

what is a drug that increases EXCRETION of uric acid (gout)?

A

sulphinpyrazone (normal renal function)
benzbromarone (impaired renal function)

example of URICOSURIC agents

18
Q

anti pain and inflammation drugs in gout?

A

nsaids

colchicine

GEM Year 1 Part II (8 decks)

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