Frequent sites of gout?
Metatarsophalangeal joint of big toe Foot Ankle Wrist Fingers Elbow
4 main signs and symptoms of gout attack
Redness heat pain swelling
When is the best time to measure serum uric acid levels
2 weeks after attack
Why might serum uric acid levels appear normal during a gout attack
During attack levels of serum uric acid may fall giving false negative
Treatments for acute gout
Cold packs
NSAIDS
Colchicine
Treatment for chronic gout
Urate lowering drugs
Define Uricaemia
Level of uric acid in the blood
Define Uricosuria
Level of uric acid in urine
2 mechanisms that can lead to hyperuricaemia
Over production of uric acid
Defect in elimination of uric acid
3 reasons for under excretion of urate
Thiazide diaretics Low dose cyclosporine A Renal insufficiency Diabetic ketoacidodis Glucose 6 phosphate deficiency
2 reasons for over production of urate
High purine diet
Treatment with chemotherapy for cancer
What is the aim of urate lowering therapy
Reduce sUA below saturation level to prevent formulation and promote dissolution of crystals
EULAR definition
European League against Rheumatism
Why should weight loss be gradual for Gout pts?
Rapid weight loss can lead to ketoacidosis which triggers gout attacks
What are EULAR guide sUA levels
What are BSR guide sUA levels
EULAR 0.36mmol/l or 6mg/dl
BSR 0.3mmol/l or 5mg/dl
What are the principle causes of a gout attack
Hyperuricemia leading to deposition of urate crystals in joints leading to inflammation
