Gout Flash Cards

Question 1

What is gout?

Answer 1

A form of inflammatory arthritis caused by monosodium urate crystal deposition in joints.

Question 2

What causes gout?

Answer 2

Elevated uric acid levels (hyperuricemia) leading to crystal deposition in joints.

Question 3

What are the common risk factors for gout?

Answer 3

Male gender, obesity, alcohol consumption, high purine diet, and diuretic use.

Question 4

What is the most commonly affected joint in gout?

Answer 4

The first metatarsophalangeal (MTP) joint, known as podagra.

Question 5

What are the clinical features of acute gout?

Answer 5

Severe joint pain, redness, swelling, and warmth, often involving one joint.

Question 6

What is chronic tophaceous gout?

Answer 6

Advanced gout with tophi (deposits of urate crystals) in soft tissues and joints.

Question 7

What dietary factors increase the risk of gout?

Answer 7

High-purine foods like red meat, seafood, and alcohol (especially beer).

Question 8

What is the gold standard for diagnosing gout?

Answer 8

Synovial fluid analysis showing needle-shaped negatively birefringent crystals.

Question 9

What is the typical serum uric acid level in gout?

Answer 9

Greater than 6.8 mg/dL, but not all patients with hyperuricemia develop gout.

Question 10

What is pseudogout?

Answer 10

Calcium pyrophosphate deposition disease (CPPD), which mimics gout but involves calcium crystals.

Question 11

What are the common triggers for acute gout attacks?

Answer 11

Alcohol intake, high-purine meals, dehydration, and sudden changes in uric acid levels.

Question 12

What is the first-line treatment for acute gout?

Answer 12

Nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin or naproxen.

Question 13

What medication is used for gout patients who cannot tolerate NSAIDs?

Answer 13

Colchicine or corticosteroids (oral or intra-articular).

Question 14

What is the mechanism of action of colchicine?

Answer 14

Inhibits microtubule formation, reducing inflammation caused by urate crystals.

Question 15

What are the common side effects of colchicine?

Answer 15

Gastrointestinal symptoms like diarrhea, nausea, and abdominal pain.

Question 16

What is the role of corticosteroids in gout?

Answer 16

Used to reduce inflammation in patients who cannot take NSAIDs or colchicine.

Question 17

What are xanthine oxidase inhibitors?

Answer 17

Medications like allopurinol and febuxostat that reduce uric acid production.

Question 18

What is the target serum uric acid level in gout management?

Answer 18

Less than 6 mg/dL to prevent gout flares and crystal deposition.

Question 19

What is the role of probenecid in gout treatment?

Answer 19

Increases uric acid excretion by inhibiting renal tubular reabsorption.

Question 20

What are tophi?

Answer 20

Deposits of monosodium urate crystals in soft tissues, often seen in chronic gout.

Question 21

What imaging finding is characteristic of chronic gout?

Answer 21

Erosions with overhanging edges, known as ‘rat bite’ lesions.

Question 22

What is the recommended dietary modification for gout patients?

Answer 22

Low-purine diet, reducing alcohol intake, and increasing hydration.

Question 23

What is the association between gout and kidney disease?

Answer 23

Hyperuricemia can lead to uric acid nephropathy and chronic kidney disease (CKD).

Question 24

What is uric acid nephrolithiasis?

Answer 24

Kidney stones composed of uric acid, commonly seen in gout patients.

Question 25

What is the role of uricosuric agents?

Answer 25

They increase renal excretion of uric acid, used in underexcretors of uric acid.

Question 26

What is the relationship between diuretics and gout?

Answer 26

Diuretics like thiazides can increase uric acid levels and trigger gout.

Question 27

What are the contraindications for allopurinol?

Answer 27

Severe renal impairment and hypersensitivity to the drug.

Question 28

What is the genetic association with gout?

Answer 28

Variants in the SLC2A9 and ABCG2 genes affecting urate transport.

Question 29

What is the mechanism of action of febuxostat?

Answer 29

Inhibits xanthine oxidase, reducing uric acid synthesis.

Question 30

What is the treatment for refractory chronic gout?

Answer 30

Pegloticase, a recombinant uricase enzyme that breaks down uric acid.

Question 31

What lifestyle changes can reduce gout flares?

Answer 31

Weight loss, regular exercise, avoiding alcohol, and staying hydrated.

Question 32

What is the role of aspirin in gout?

Answer 32

Low-dose aspirin can increase uric acid levels and is generally avoided.

Question 33

What is the relationship between metabolic syndrome and gout?

Answer 33

Metabolic syndrome increases the risk of hyperuricemia and gout.

Question 34

What are the complications of untreated gout?

Answer 34

Chronic joint damage, tophi formation, kidney stones, and nephropathy.

Question 35

What is the first step in managing a patient with suspected gout?

Answer 35

Synovial fluid aspiration and analysis to confirm crystal presence.

Question 36

What are the long-term medications for gout management?

Answer 36

Allopurinol, febuxostat, and uricosuric agents like probenecid.

Question 37

What is the risk of starting urate-lowering therapy during an acute gout attack?

Answer 37

It can exacerbate the attack; therapy should be started after inflammation subsides.

Question 38

What is the role of lifestyle modification in gout prevention?

Answer 38

Reduces uric acid levels and decreases the frequency of gout attacks.

Question 39

What are the indications for initiating urate-lowering therapy?

Answer 39

Frequent gout attacks, tophi, joint damage, or kidney stones.

Question 40

What is the recommended hydration level for gout patients?

Answer 40

At least 2-3 liters of water per day to prevent uric acid crystallization.

Question 41

What is the primary cause of hyperuricemia in gout?

Answer 41

Impaired renal excretion of uric acid or overproduction of uric acid.

Question 42

What is the difference between primary and secondary gout?

Answer 42

Primary gout is idiopathic; secondary gout is due to underlying conditions like CKD or malignancies.

Question 43

What is the role of vitamin C in gout prevention?

Answer 43

May reduce uric acid levels and lower gout risk.

Question 44

What is the duration of an acute gout attack?

Answer 44

Typically resolves within 3-10 days with appropriate treatment.

Question 45

What is the effect of alcohol on gout?

Answer 45

Increases uric acid levels by reducing renal excretion and increasing purine metabolism.

Question 46

What foods should gout patients avoid?

Answer 46

Organ meats, shellfish, red meat, and high-fructose corn syrup.

Question 47

What is the role of dairy products in gout?

Answer 47

Low-fat dairy products may reduce uric acid levels and lower gout risk.

Question 48

What is the relationship between gout and cardiovascular disease?

Answer 48

Gout is associated with an increased risk of hypertension, MI, and stroke.

Question 49

What is podagra?

Answer 49

Acute gout affecting the first metatarsophalangeal joint.

Question 50

What is the role of losartan in gout management?

Answer 50

It lowers uric acid levels and can be used in hypertensive gout patients.

Question 51

What are the features of intercritical gout?

Answer 51

Asymptomatic periods between acute gout attacks.

Question 52

What is the effect of obesity on gout?

Answer 52

Increases uric acid production and decreases renal excretion.

Question 53

What is the role of NSAIDs in chronic gout management?

Answer 53

Used for acute attacks but not recommended for long-term urate-lowering therapy.

Question 54

What is the mechanism of urate crystal formation?

Answer 54

Occurs when serum uric acid exceeds its solubility threshold (6.8 mg/dL).

Question 55

What is the importance of patient education in gout management?

Answer 55

Helps patients adhere to lifestyle changes and medication regimens.

Question 56

What is monosodium urate?

Answer 56

The type of crystal responsible for gout.

Question 57

What is calcium pyrophosphate dihydrate (CPPD)?

Answer 57

The type of crystal responsible for pseudogout.