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Terms in this set (19)
metabolic disease,caused by a derangement in purine metabolism,resulting in:
-urate crystal depisition in tissue called TOPHI and in synovium MICROTHOPHY
Plasma and extracellular fluids become supersaturated with urica acid; and crystalizes and provoke an inflammatory pain ful reaction
inflamamtory arthritis caused by hyperuricemia and intra-articular sodium urate crystals.
uric acid is the end product of purine metabolis.
normally it is excreted by kidneys.
reabsorption of uric acid in the kidney,it is stronglt linked to sodium reabsorption.
plasma urate concentration over 420 micromol/l
over production 10%
the crystal themeselves are not irritating,but evoke and intense autoimmune reaction when phagocytosed by PMN.
lysosomes and other enzymes lreleased during this reaction leads to joint destruction.
etiology of hyperuricemia
secondary : acquired
renal : idiopathic undersecretion
increased nucelic acid turnover or glucose 6 phosphate deficiency.
acute or chronic renal vfailure
what conditions can cause gout?
what drugs can cause gout?
precipitants of gout
Drugs are FACT
drugs are FACT
PRECIPITANTS OF GOUTS
Foods are SALTS
Foods are SALTS
LIVER AND KIDNEY
Complications/clinical manifesationd of hyperuricemia?
describe gouty arthirits
peak onset 45 y
pain ful arthritis!! 90% monoarticualr!
1st metatarsophalangeal joint usually
reduced joint mobility
Attack is self litimg and shoud resolve within days to weeks
dg of painful gouty arthritis
joint aspiration: polarized lens demonstrate needle shaped monosodium urate crystals in synovial fluid.
x ray: may show tophi as soft tissue swelling or punched out lesion
treatment of acute gout
high dose NSAID
Colcihicine within 24 h
treatment of chronic gout
Avoid food with purine increased ccontent
avoid drugs with hyperuremic effect:alcohol,thiazides ets
ALLPURIONOL: Xanthine ocidase inhibiotr : do not start during acute flare
what can hyperuricemia cause in renal disease
nephrolithiasis : uric acid stone
urate nephropathy: deposition of urate crystals in the medullary interstitium
uriac acid nephropaty: reversible acute renal fialure due to precipitation of ua in renal tubules
OTHER SETS BY THIS CREATOR
hyper and hypocalcemia
connective tissue diseases
Examination methods in rheumatology
OTHER QUIZLET SETS
Fluid and Electrolytes (ch 6 pg 345-353)
IHI Introduction to Patient Safety
5081 Praxis Study Set