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CRYSTAL ARTHOPATHIES

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tomi1's version from 2017-03-07 23:11

Section 1

Question Answer
Gout presentationacute monoarthritis
gout pathologyprolonged hyperuricaemia-crystals synovium-inflammation PML-cartilage loss+sclerotic changes
triggersdiuretics-alcohol-infection-starvation- chemotherapy-starting allopurinol
gout in which group womenpostmenopausal women
indication allopurinoltophi,recurrent attacks, kidney disease,radiographic damage
allopurinol cannot be started during acute attack worsens pain
define tophi and sitesfirm nodules of urate crystals- olecranon bursae,ear pinna,hands+feet
what is podagra tender,red,hot base of big toe overnight
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Section 2

Question Answer
how is gout diagnosedhistory and exam
do patients need an x-rayno - can show chronic changes
blood test for gouturate, U+E
do patients need joint aspiration YES
why do you need to check U+Erenal impairement is a trigger for gout
which bloods checked if alcohol relatedGGT, MCV
site of uric acid synthesis and excretionliver and kidney (2/3rd daily)
memorize

Section 3

Question Answer
management acute gout -drugs stopdiuretics
management acute gout -drugsnsaids-colchicine (probenecid,sulphinpyrazole)
se uricosuric drugs (increase uric acid excretion)vomitting, dyspepsia
se allopurinol rash, hepatitis
what is prophylatic management goutxanthiane oxidase inhibitors (allopurinol)
target range of uric acid on alloupurinol<0.42mmol/l
memorize

Section 4

Question Answer
most common acute monoarthritis elderlypsuedogout
site psuedogoutknee,wrist,shoulder
xray changes psuedogoutCHONDROCALCINOSIS: appears as opafication joint cartilage margin
associated pathology with goutOA, hyperparathyroid, haemochromatosis
memorize