gout

Question 1

Causes hyperuricaemia

Answer 1

urate overproduction - myeloproliferative, high intake, alcohol

reduced excretion- intrinsic renal under excretion, obesity, drugs

Question 2

drugs causing hyperuricaemia

Answer 2

aspirin
diuretics
cyclosporin

Question 3

common areas gout affect

Answer 3

Big toe
Mid tarsal
Ankle

Question 4

Gout X ray

Answer 4

No joint space loss

erosions (different to RA)-punched out + overhanging edges,

Question 5

colchicine side effect

Answer 5

Diarhoea

Neuromyopathy- proximal muscle weakness, mild axonopathy, vacuolar myopathy

Question 6

mechanism action urate lowering therapies

Answer 6

allopurinol - inhibits xanthine to urate

probenacide- increase urate secretion

peglouricase- uric acid to allantoin- increased solubility increased excretion

Question 7

When use urate lowering theraphy

Answer 7

tophi
>2 attack an year
urate nephropathy
urate renal stones
x ray - erosions