Gout

Question 1

Gout

Answer 1

Type of inflammatory arthritis

Excess of uric acid and its salts (rates) to accumulate in the blood-stream and the joints respectively.

Question 2

Gout Aetiology

Answer 2

Deposition of monosodium urate crystals

• needle shaped
• Negatively birefringent

High uric acid levels

• Increased protein intake
• Increased cell breakdown
• Renal under excretion
• Diuretics
• Renal failure
• Excessive alcohol intake
• Diet

Question 3

Gout Symptoms

Answer 3

Intensely painful
Red, hot, swollen
May mimic septic arthritis
Rapid Onset
Gouty tophi (painless white accumulations which can occur in soft tissues and occasionally erupt through the skin)

Question 4

Gout Investigations

Answer 4

Joint Aspiration

Serum Urate >7mg/dL

Question 5

Gout Common Sites

Answer 5

Any site

1st MTP Joint
- Podagra

Ankle joint

Knee joint

Question 6

Gout Triggers

Answer 6

Dehydration
Trauma
Surgery

Question 7

Gout Treatment

Answer 7

Acute

• NSAIDs
• Corticosteroids
• Opioid analgesia
• Colchicine (if NSAID intolerant)

Chronic

• Allopurinol
• Febuxostat

Question 8

Pseudogout

Answer 8

Joint pain and swelling, resembling gout, caused by crystals of calcium pyrophosphate synovial membrane and fluid

Question 9

Pseudogout aetiology

Answer 9

Calcium pyrophosphate dehydrate crystal deposition

- Rhomboid Shaped

Question 10

Pseudogout Common Sites

Answer 10

Knee
Wrist
Ankle

Question 11

Pseudogout Associations

Answer 11

Hyperparathyroidism
Hypothyroidism
Renal osteodystrophy
Haemochromatosis
Wilson's disease