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