Lecture 18 Crystal Arthropathy Flashcards Preview

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Flashcards in Lecture 18 Crystal Arthropathy Deck (16)
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1
Q

Name 3 common crystal deposition disease

A

o Monosodium urate - gout
o Calcium pyrophosphate dihydrate (CPPD) - Pseudogout
o Basic calcium phosphate hydroxy-apatite (BCP) – calcific periarthritis/tendonitis

2
Q

In terms of Hyperuricaemia what causes overproduction

A

Malignancy, severe exfoliative psoriasis, drugs (ethanol, cytotoxic drugs), Inborn errors of metabolism, HGPRT deficiency

3
Q

In terms of Hyperuricaemia what causes under excretion

A

Renal impairment, hypertension, hypothyroidism, Drugs (alcohol, low dose aspirin, diuretics, cyclosporin), exercise, starvation, dehydration, lead poisoning

4
Q

What is Lesch Nyan Syndrome

A

HGPRT deficiency

5
Q

What is HGPRT

A

An enzyme that plays a key role in recycling of the purine bases, hypoxanthine and guanine into the purine nucleotide pools.

In absence of HPRT, these purines are degraded and excreted as uric acid

6
Q

What are the clinical features of Lesch Nyan Syndrome

A

Gout, renal disease, intellectual disability, X-linked recessive, self-mutation, aggressive and impulsive behaviour

7
Q

How is gout managed in an acute flare

A

NSAIDs, Colchine, Steroids (I/A, I/M, oral)

8
Q

Name drugs used to lower Uric Acid

A
  • Xanthine oxidase inhibitor e.g. Allopurinol
  • Febuxostat
  • Uricosuric agents e.g. sulphinpyrazone, probenecid, benzbromarone
  • Canakinumab
9
Q

What is the aetiology of Pseudogout

A

Idiopathic, familial, metabolic

10
Q

What are the triggers for Pseudogout

A

Trauma, intercurrent illness

11
Q

What is the difference between Gout and Pseudogout

A

While gout is caused by uric acid crystals; pseudogout is caused by calcium pyrophosphate dehydrate crystals (CPPD)

12
Q

What is the management of Pseudogout

A

NSAIDs, I/A steroids

13
Q

What is Polymyalgia Rheumatica

A

Inflammatory disorder that causes muscle pain and stiffness

14
Q

How is Polymyalgia Rheumatica diagnosed

A
Compatible history
Age>50
ESR>50
Dramatic steroid response
No specific
15
Q

What are the differential diagnosis Polymyalgia Rheumatica

A

Underlying malignancy, inflammatory muscle disease, hypo/hyperthyroidism, fibromyalgia, bilateral shoulder capsulitis

16
Q

How is Polymyalgia Rheumatica treated

A

Prednisolone

Bone prophylaxis- Bisphosphonates

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