Gout Flashcards
(25 cards)
3 types crystal induced arhtrits
gout
CPPD
BCP
crystal induced arthritis
articualr disease mediated by metabolic changes related to deposition of crystals within joint or periarticular tissue
who rarely gets gout?
premenopausal women
uric acid in gout
> / 6.8 mg/dl
what is increase uric acid due to
increase in purine breakdown
decrease in excretion (more common)
what elevates uric acid
meds (thiazides limit excretion)
iatrogenic (tumor lysis syndrome)
alch (beer >liquor>wine)
gout is classified as
mono/oligoarthritis –>resolves in seven days
podagra
hot, swollen, painful
MTP cmmon
tophi
clusters or cocentrations of gouty depositions
stage I of gout
asymp hyperuricemia
stage 2 of gout
acute intermittent arthritis
stage 3 of gout
chornic arthritis with acute exacerbations
**may see tophi and cartilage
gout acute tx
indomethacin (NO in RF)
steroids (systemic or local)
colchicine (not strong enough)–caution in RF
decrease fq flairs
colchicine
decrease fq flairs/UA crystals
allopurinol- stop during acute attack (skin rash, caution in RF)
probenecid (increase UA secretion- not great, lots of side effects)
you can increaase allopurinol
even when UA is in normal range
febuxostat
people in RF can take thsi isntead of allopurinol, but its very expensive
CPPD favors
bigger jts (knees, ankles, wrists)
dx CPPD
aspiration
xrays in CPPD
can see chrondrocalcinosus (ca in cartilage)
acute Tx of CPPD
rest, nsaids, steroids, colchicine
colchicine in CPPD
sometimes given prophylactically
BCD aka
calcific tendititis/bursitis, hydroxyapatite disease
dx of BCP
calcific tenditis, acute or chronic synovitis (harder to dx because unable to see crystals without special stain)
