GOUT Flashcards
(27 cards)
what causes GOUT
the accumulation of monosodium urate crystals in and around the joints.
define GOUT
A type of arthritis where urate crystals are deposited in joints, and it is associated with high uric acid levels in the blood.
what is GOUT characterised by
sudden, severe attacks of pain, swelling, redness, and tenderness in the joints.
what is the most common inflammatory arthritis in the UK
GOUT
non modifiable risk factors for GOUT
- Male sex
- Age >50
- Family history
- Overproduction of uric acid.
modifiable risk factors for GOUT
- Obesity
- Hypertension
- CKD
- Diabetes
- High purine diet (meat and seafood)
- Medications (thiazides, ACEi, asprin)
what is the impact of GOUT triggers
Gout has several triggers/precipitating factors that can cause an acute flare, usually due to production of uric acid.
give 6 triggers for GOUT
- Seafood/protein binges
- Chemotherapy
- Trauma and surgery
- Alcohol excess (PURINES)
- Intercurrent illness
- Medications (interfere with uric acid)
signs and symptoms of gout
- Excruciating, sudden, burning pain in the affected joint
- Swelling, redness, warmth, and stiffness in the affected joint
- Asymmetric joint distribution
- Mild fever
- Tachycardia (sympathetic response to an acute attack)
which food is anti GOUT
dairy
does GOUT affect one joint or multiple
one - it is monoarticular
how is monosodium urate formed
purines –> uric acid –> monosodium urate
which joint does gout most commonly affect
the base of the big toe - metatarsophalangeal joint
other jounts commonly affected by gout
- wrists
- bases of thumb (carpometacarpal joints)
give 4 investigations for gout
- joint aspirate
- serum uric acid level
- x rays
- ultrasound
what does joint aspiration & polarised light microscopy for gout show
- needle like negative birefringent crystals
- monosodium urate crystals
- no bacterial growth
what does serum uric acid level show for gout
high level indicates diagnosis
what does x ray of affected joint for gout show
punched-out erosions
what does ultrasound of affected joint for gout show
double-contour sign
first line treatment for acute flares of gout
NSAIDS (+PPI) - FIRST LINE
second line treatment for acute flares of gout
Colchicine - SECOND LINE
third line treatment for acute flares of gout
Oral Steroids - THIRD LINE
3 ways to prevent gout
- Xanthine oxidase inhibitors (lower the uric acid levels)
- Allopurinol
- Febuxostat
- Medication reviews (some may cause hyperuricaemia)
- Lifestyle changes/avoiding triggers can also reduce the risk of gout.
which patients is colchicine given to
those who cannot have NSAIDS