Gout Flashcards
What is gout?
The most common inflammatory and metabolic joint disorder caused by the deposition of monosodium urate crystals in joints and soft tissues following chronic hyperuricaemia.
What causes chronic hyperuricaemia?
Disorders of purine metabolism due to underexcretion or overproduction of uric acid.
What is the primary cause of hyperuricemia in about 90% of cases?
Under-excretion of uric acid by the kidney.
What are tophi?
Hard, painless deposits of uric acid crystals that may lead to chronic arthritis due to bone erosion.
What is the end product of purine degradation in humans?
Uric acid.
What enzyme breaks down uric acid in lower animals?
Uricase.
What are the three sources of purines that lead to uric acid production?
- Dietary purine * Conversion of tissue nucleic acid to purine nucleotides * De novo synthesis of purine
What is the classification of gout based on?
The presence or absence of an identified cause of hyperuricaemia.
What is primary gout?
Gout where the basic metabolic defect is unknown, developing due to genetic, diet, and environmental factors.
What are common signs and symptoms of gout?
- Sharp pain * Warmth and swelling * Inflammation in joints * Fever * Fatigue * Erythema
Which joint is most often affected by gout?
The metatarsal-phalangeal joint at the base of the big toe.
What triggers inflammation in gout?
Precipitation of urate crystals in the joints.
What role does IL-1β play in gout?
It stimulates the production of chemokines and other cytokines from tissue cells.
What dietary factors can increase the risk of gout?
- High consumption of alcohol * Sugar-sweetened beverages * Meat * Seafood
What is the definitive diagnosis of gout based on?
Identification of monosodium urate crystals in synovial fluid or a tophus.
What is the initial aim of gout treatment?
To settle the symptoms of an acute attack.
What is the first-line treatment for gout?
NSAIDs.
What is allopurinol used for?
To decrease high blood uric acid levels and prevent gout.
What is the mechanism of action of allopurinol?
It inhibits the enzyme xanthine oxidase, reducing uric acid production.
What are common side effects of allopurinol?
- Itchiness * Rash * Hypersensitivity syndrome * Vomiting * Kidney problems
What is febuxostat used for?
To treat gout and hyperuricemia, especially in those who cannot take allopurinol.
What is the mechanism of action of febuxostat?
It is a non-purine-selective inhibitor of xanthine oxidase.
What is probenecid’s function in gout treatment?
It increases uric acid excretion in urine.
What is pegloticase used for?
Severe, treatment-refractory chronic gout.
