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Flashcards in Gout- Sum Deck (17):
1

SUL

4.0. -6.8

2

> 6.8

Precipitation

3

Other factors that may influence precipitation of crystals

Low pH
Low temp
Immune response

4

Predisp to Gout

Obesity,
Kidney prob
Inc protein diet, alcohol
Drugs
Genetics
CAD
Hypothyroidism

5

Gout most commonly occur

1st MPJ

6

Hyperuricemia

Overproduction (10%)

1- metab error
2- inc mitosis, inc DNA/RNA, inc purine

7

Underexcretion (90%)


DEALT

1- hereditary renal tube pro
2- renal failure, drugs(thiazide diuretics, loop diuretics, EtOH, ASA)

8

Stages of gout

Asymptomatic
Acute
Intercritical
Chronic

9

Stages of gout

Asymptomatic

Inc urate SL w/o attack

10

Stages of gout

Acute

Inflam, swelling, erosion,
No tophi
Painful
Sloughing skin

11

Stages of gout

Intercritical

Time between attacks- 6m- 2yrs after 1st attack

Xray changes -erosive, periarticular calcification

12

Stages of gout

Chronic

Painful all the time
Tophi w soft tissue swelling
Martel sign ,>5mm erosions
Soft and joint tissues attack ( joint space preserve)

13

Gout diagnosis

Joint aspiration
Xray
Ultra sound
Labs-CBC, RF, uric acid

14

Treatment(general)

W/in 24h of attack

Colchicine-1.2->(1 h later) 0.6 =1.8

Indomethacin (NSAID)- 50->(8h) 50; max 200

Corticosteroid - INtra, oral, IM, IV

ACTH -IM

15

Treatment(prophyl)

Colchicine- 0.6 mg 1-2 tabs daily (until hyperurecemia, no attack for 3-6 m)

16

Treatment (hyperuricemia control)



AX PUS Puk

Xanthine oxidase- allopurinol
Uricosuric agents- probenecid, sulfinpyrazone
Uricases- krystexxa, pegloticase (severe tophaceous gout)

17

M>F

30 yrs, Avg 50yrs

Formation of uric acid in urate form w elevated levels; precipitation of urate into a crystallized form occurs

Gout