Gout & Pseudogout Arthritis

Question 1

Onset is _________ / how many joints if acute / how many if chronic? / Demographic

Answer 1

Acute, nocturnal / monoarticular / polyarticular / Middle aged men over 30 (90%) then post-menopausal women

Question 2

Joint if usually affects / term for this type of pain

Answer 2

Big toe / Podagra

Question 3

Type of drugs that exacerbate gout?

Answer 3

Thiazides and loop diuretics (diuretics)

Question 4

Lab findings with gout:

Answer 4

Inflammation I (WBCs between 2,000 and 75,000) but not over 100,000.

Question 5

Causes of gout flare ups

Answer 5

Alcohol (beer), sea food, dehydration; rapid changes in uric acid levels

Question 6

Gout rarely affects:

Answer 6

hips and shoulders

Question 7

Skin over gouty flare up / assc sx:

Answer 7

Swollen, tender, tense, warm, dusky red / Fever

Question 8

Chronic gout becomes ____________ and mimics ___________.

Answer 8

polyarticular / RA

Question 9

On XR, what finding is characteristic of Gout? / Or Pseudogout?

Answer 9

Rat Bite Ulcerations / Chondrocalcinosis - crystals in cartilage

Question 10

Under microscope, how will gout look? / Pseudogout?

Answer 10

Urate crystals, negative birefringement / Calcium Pyrophosphate Crystals, positive birefringement

Question 11

When should you start treating hyperuricemia?

Answer 11

When it is symptomatic.

Question 12

What medications do you use to treat ACUTE gout?

Answer 12

full dose of NSAID or Colchisine or Corticosteroids

Question 13

Non pharm management

Answer 13

Control diet, control weight, avoid diuretics

Question 14

When to use a drug to lower Uric Acid levels?

Answer 14

Frequent acute arthritis (2 episodes / year), tophaceous deposits, chronic kidney disease

Question 15

Give 2 examples of Xanthine Oxidase Inhibitors / MOA / stop for:

Answer 15

Allopurinol, Febuxostat / blocking the final enzymatic steps in the production of uric acid / pruritic rash`

Question 16

Population that is particularly susceptible to gout:

Answer 16

Transplant

Question 17

Where are CPPD crystals found

Answer 17

Fibrin and hyaline cartilage

Question 18

Difference in age group btw gout and pseudogout

Answer 18

Middle age men / over 60

Question 19

Joints involved in pseudogout / how many joints? / chronic vs nonchronic

Answer 19

Large joints - knees, wrists / oligoarticular / nonchronic

Question 20

Iatrogenic cause of gout and pseudogout

Answer 20

24 to 48 hours of hospitalization