Crystal arthropathies Flashcards Preview

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Flashcards in Crystal arthropathies Deck (14):
1

Gout vs pseudogout

Gout: urate crystals, negatively birefringent, needle crystals
Pseudogout: calcium pyrophosphate crystals, positively birefringent, rhomboid shaped crystals

2

Treatment for acute gout

Naproxen first line
If contraindicated give colchicine
If renal impairment give steroids

3

Treatment for chronic gout

Allopurinol with initial cover by steroids/NSAID/colchicine

4

MoA of allopurinol

Xanthine oxidase inhibitor therefore no effect in acute

5

CI for allopurinol

Azathioprine as leads to very high 6-MP levels

6

How does gout progress over time

Acute episodes more severe
More joints affected
Periods between acute episodes shorten

7

Appearance of gout

Pain, erythema, stiffness and swelling of one joint
Tophi due to urate crystal deposition

8

X ray appearance

Juxta-articular punched out erosions

9

What can precipitate attack of gout

Trauma
Surgery
Diuretics (thiazides)
Infection

10

What should you screen for in someone with chronic gout

CKD
Hypertension
Diabetes
Dyslipidaemia

11

Lifestyle advice in gout

Avoid alcohol, purine rich meat ad low dose aspirin
Lose weight

12

Side effects of allopurinol

Rash
Fever
Neutropenia

13

When should gout prophylaxis be initiated

More than 1 attack within 1 year
Tophi
Renal stone

14

Risk factors for pseudogout

Hyperparathyroidism
Haemochromatosis
Hypophosphataemia