Gout

Question 1

what is gout

Answer 1

crystal induced joint disease

Question 2

what are the crystal deposits formed from

Answer 2

uric acid

Question 3

what types are there

Answer 3

primary and secondary

Question 4

which is most common in men

Answer 4

primary

Question 5

primary are usually caused from

Answer 5

metabolic problem

Question 6

secondary are usually caused from

Answer 6

cell destruction (leukemia)
renal problem
alcohol
chem

Question 7

Primary Patho

Answer 7

altered purine metabolism - asymptomatic hyperuricemia

Question 8

what is purine metabolism

Answer 8

break down of the bases adenine and guanine

Question 9

what is hyperuricemia

Answer 9

increase uric acid in the blood

Question 10

what happens to this uric acid later on

Answer 10

uric acid forms crystals in the synovial fluid and deposits in the synovial joints

Question 11

these crystal deposits trigger…

Answer 11

WBC influx and complement activation (leukocytes die when they phagocytize the crystals) - they release an enzyme - this enzyme targets the joints causing inflammation and damage

Question 12

what occurs with recurrent attacks

Answer 12

tophus

Question 13

what is tophus

Answer 13

crystalline uric acid at surface of joints or in the skin of cartilage

Question 14

how many stages are there of gout

Answer 14

5

Question 15

what are these stages

Answer 15

1. asymptomatic hyperuricemia
2. acute inflammation (usually at the toe joint)
3. subsides in ~ 1 week
4. asymptomatic for months to years
5. frequent recurrent attacks = permanent damage to joints

Question 16

Diagnosis

Answer 16

Serum: uric acid
Urinalysis: uric acid
xray to see uric acid in the joints

Question 17

Treatment

Answer 17

Acute attacks are (pain and inflammation)

• NSAIDS
• OR colchicine
• OR steroids

Question 18

what is colchicine

Answer 18

limits the migration of leukocytes (stopping them from phagocytizing the crystal = therefor stopping enzymatic breakdown)

Question 19

other Treatment

Answer 19

decrease hyperuricemia
- increase secretion of uric acid
- increase fluids
eliminate alcohol
decrease proteins in diet