post-menopause
When do women reach the same levels of uric acid as men?
diuretics, nicotinic acid, salicylates (<2g/day), ethanol, pyrazinamide, levodopa, ethambutol, cytotoxic drugs, cyclosporine
Which drugs may induce hyperuricemia and gout? (9)
podagra
-acute inflammatory monoarthritis affecting the 1st metatarsal-
phalangeal joint
tophi
-aggregated deposits of sodium urate in cartilage, tendons, synovial membranes, and elsewhere
wrist; finger
Gout occasionally presents itself as monoarthritis of the ______ or _____.
fever, intense pain, erythema, warmth, swelling/inflammation of involved joints, podagra
Signs/symptoms of Acute Gout? (6)
observation of monosodium urate crystals in synovial fluid/tophus aspiration
What diagnostic tests are available for Gout?
serum uric acid levels, CBC, renal function, liver enzymes, electrolytes
What laboratory tests are used for Gout? (5)
a
Which is characterized by asymptomatic periods between attacks?
a) interval gout
b) gouty nephropathy
c) atypical gout
d) classic presentation
e) tophaceous gout
d
The 1st metatarsal phalangeal joint is swollen, erythematous, and
tender.
a) interval gout
b) gouty nephropathy
c) atypical gout
d) classic presentation
e) tophaceous gout
soft tissue damage, deformity, joint destruction, nerve compression, carpal tunnel
What are the complications associated with Tophaceous Gout? (5)
e
Which gout is characterized by deposits of MSU crystals in soft tissue?
a) interval gout
b) gouty nephropathy
c) atypical gout
d) classic presentation
e) tophaceous gout
c
Which gout is characterized by polyarthritis affecting any joint in the lower or upper extremities?
a) interval gout
b) gouty nephropathy
c) atypical gout
d) classic presentation
e) tophaceous gout
b
Which form can cause acute and chronic renal impairment?
a) interval gout
b) gouty nephropathy
c) atypical gout
d) classic presentation
e) tophaceous gout
within 24 hours
When should treatment begin in Acute Gout attacks?
NSAIDs, colchicine, corticosteroids, IL-1 inhibitors
Which medication classes are used for Acute gout? (4)
indomethacin, naproxen, sulindac
Which NSAIDs have been FDA-approved to treat gout? (3)
5-8 days
How long is NSAID treatment for Acute Gout?
b
Which is the mainstay of therapy for Acute Gout?
a) colchicine
b) NSAIDs
c) IL-1 inhibitors
d) corticosteroids
d
Which is reserved for acute gout flares when contraindications to other therapies are present?
a) colchicine
b) NSAIDs
c) IL-1 inhibitors
d) corticosteroids
intra-articular/oral therapy; systemic therapy
When 1-2 joints are affected, _______ therapy is recommended. When gout
is polyarticular, ________ therapy is necessary.
SC/IM
What are the dosage forms for ACTH gel?
give in 1st 24 hours, only use within 1st 36 hours, use carefully in patients with renal/hepatic insufficiency
What are the ACR guidelines regarding Colchicine use? (3)
prednisone, prednisolone, medrol dose pack
Which oral corticosteroids are ACR recommended? (3)
Intra-articular injection of triamcinolone; 1-2
________ can be used for attacks limited to _______ joints.
IM injection of methylprednisolone + oral corticosteroid therapy
What is the treatment for patients with multiple affected joints unable to
take oral steroid therapy?