Gout Flashcards
(17 cards)
What is gout?
An inflammatory arthritis caused by monosodium urate crystal deposition in joints. Patients have discrete episodes lasting several days followed by being symptom free
Gout is characterized by sudden and severe pain, redness, and swelling in the affected joints.
How is an acute episode of gout treated?
Colchicine and NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain and inflammation.
What is the prophylaxis for gout?
Allopurinol with colchicine, 1st line, Febuxostat with colchicine, 2nd line
Prophylactic treatment aims to lower uric acid levels and prevent future attacks.
When is gout prophylaxis offered?
Offered after the first flare has settled. During subsequent flares can continue taking them
Prophylaxis is important to prevent recurrent episodes and complications.
What are some lifestyle modifications to reduce gout?
Reduce alcohol intake, reduce purine rich foods, weight loss if obese
Lifestyle changes can significantly impact the frequency and severity of gout attacks.
What joint is most commonly affected by gout?
MTP of foot
The metatarsophalangeal joint at the base of the big toe is the classic site for gout attacks.
What other joints are affected by gout?
Ankle, feet, hand joints, wrist, elbow, knee
Gout can affect multiple joints, particularly in more severe cases.
What crystals are seen in gout on joint aspiration?
Negatively birefringent needle shaped crystals
These crystals are indicative of gout and can be visualized under polarized light microscopy.
What radiological features are associated with gout?
Punched out erosions with overhanging edges
Preservation of joint space
Eccentric erosions
These features help distinguish gout from other forms of arthritis on imaging studies.
What drug(s) may exacerbate gout?
Thiazides, ARBs i.e. Losartan
Certain medications can increase uric acid levels, leading to exacerbations of gout symptoms.
What is Pseudogout?
A crystal arthropathy caused by deposition of calcium pyrophosphate
Pseudogout is also known as calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.
What type of crystals are seen in Pseudogout?
Positively birefringent rhomboid shaped crystals
These crystals can be identified under polarized light microscopy.
What is seen on XR in cases of Pseudogout?
Chondrocalcinosis
Chondrocalcinosis refers to the calcification of cartilage, often visible on X-ray.
What are the risk factors for Pseudogout?
Haemochromatosis, Acromegaly, Wilson’s Disease, low Mg, low Phosphate, hYPERparathyroidism
These conditions can contribute to the development of calcium pyrophosphate crystal deposits.
What is the management for Pseudogout?
NSAIDs, Steroids
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are commonly used to reduce inflammation and pain.
What are the features of gout?
Single, hot painful joint
Tophi
Risk factors for gout?
Male
Family history
Obesity
High purine diet
Alcohol
Diuretics
Cardiovascular disease
Kidney disease
