Gout and Other Crystal-Associated Arthropathies Flashcards Preview

Rheuma (HPIM 18e) > Gout and Other Crystal-Associated Arthropathies > Flashcards

Flashcards in Gout and Other Crystal-Associated Arthropathies Deck (30):
0

Polarized microscopy alone can identify most typical crystals except this one

Apatite

1

Most common early clinical manifestation of gout

Acute arthritis

2

Most commonly involved joint in gout

1st MTP

3

Characteristic of monosodium urate crystals on polarized microscopy

Brightly birefringent with negative elongation; needle-shaped

4

Arthrocentesis of these joints is a useful technique to establish the diagnosis of gout between attacks because MSU crystals can be demonstrated even when they are not acutely involved with gout

1st MTP and knees

5

Reason why serum uric acid may be normal or low at the time of an acute attack of gout

Inflammatory cytokines can be uricosuric

6

Excretion of this amount of uric acid per 24 h on a regular diet suggests that causes of overproduction of purine should be considered

>800 mg in 24 h

7

Mainstay of treatment during an acute gouty attack

Anti-inflammatory drugs (NSAIDs or glucocorticoids)

8

Best drug to lower serum urate in overproducers, urate stone formers, and patients with renal disease

Allopurinol

9

Uricosuric drug that is more effective than probenecid in patients with renal failure

Benzbromarone

10

Toxicity of allopurinol has been recognized increasingly in patients who use this diuretic

Thiazide

11

Toxicity of allopurinol has been recognized increasingly in patients who are allergic to these antibiotics

Penicillin and ampicillin

12

Most serious side effects of allopurinol

TEN, systemic vasculitis, bone marrow suppression, granulomatous hepatitis, renal failure

13

A specific xanthine oxidase inhibitor that does not require dose adjustment in mild to moderate renal disease

Febuxostat

14

Duration of colchicine prophylaxis in patients given hypouricemic therapy

Until patient is normouricemic and without gouty attacks for 6 months or as long as tophi are present

15

A new urate-lowering biologic agent that can be effective in patients allergic to or failing xanthine oxidase inhibitors

Pegloticase

16

Mutations in this gene can increase elaboration and extracellular transport of pyrophosphate, leading to CPPD arthropathy

ANKH gene

17

Most frequently affected joint in CPPD arthropathy

Knee

18

Findings of punctate and/or linear radiodense deposits in fibrocartilaginous joint menisci or articular hyaline cartilage; seen in CPPD arthropathy

Chondrocalcinosis

19

Polarized light microscopy findings in pseudogout (CPPD arthropathy)

Rhomboid, square, or rodlike crystals with weak positive birefringence

20

Chondrocalcinosis not due to CPPD deposition in patients with chronic renal failure is due to accumulation of this crystal

Calcium oxalate

21

Prophylactic treatment for frequent recurrent attacks of pseudogout

Colchicine

22

Primary mineral of normal bone and teeth

Apatite

23

Destructive chronic arthropathy of the shoulder in the elderly, associated with apatite deposition disease

Milwaukee shoulder

24

Most common sites of apatite deposition are the bursae and tendons in and around these joints

Knees, shoulders, hips, and fingers

25

Usual synovial fluid leukocyte count in calcium apatite deposition disease

<2000/uL

26

Type of microscopy used in the definitive diagnosis of apatite arthropathy

Electron microscopy

27

Color of apatite aggregates with Wright's stain

Purple

28

Color of apatite aggregates with alizarin red S stain

Bright red

29

Vitamin that should be avoided in renal failure patients because it is metabolized to oxalate and is inadequately cleared in uremia and by dialysis

Ascorbic acid