Assisst. Prof. Hassan Khuder Rajab 2nd Class

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What is the recommended initial oral dose of colchicine for acute attacks of gouty arthritis?

0.5 mg

2 mg

3 mg

1 mg (correct)

Why should IV colchicine be avoided?

Because it leads to increased renal function

Due to bone marrow suppression (correct)

To prevent tissue necrosis from local extravasation

For treating disseminated intravascular coagulation

How should the initial IV dose of colchicine be administered?

Slowly over 10 to 20 minutes in a secure IV line (correct)

Mixed with a high concentration of dextrose for rapid infusion

Rapidly in a large single bolus injection

Administered as a push via a peripheral IV line

After completing a full IV course of colchicine, how long should patients wait before receiving colchicine by any route?

At least 7 days Signup and view all the answers

In what situations are corticosteroids primarily reserved for the treatment of acute gouty arthritis attacks?

Patients who are unresponsive to NSAID or colchicine therapy Signup and view all the answers

What is the recommended dose of prednisone for treating acute attacks of gouty arthritis?

30-60 mg Signup and view all the answers

Why are corticosteroids also used in patients with multiple-joint involvement in gouty arthritis?

To provide additional pain relief Signup and view all the answers

What is a potential serious adverse effect associated with IV colchicine administration?

Renal failure Signup and view all the answers

What is the recommended approach for tapering the dose of corticosteroids to avoid rebound attacks?

Gradually taper the dose by 5 mg over 10 to 14 days and then discontinue Signup and view all the answers

Which route of administration can be used as an alternative to oral corticosteroids if patients are unable to take oral therapy?

Intramuscular injection of a long-acting corticosteroid Signup and view all the answers

What adjunctive therapy can be used with injectable corticosteroids to prevent rebound flare-ups, if not contraindicated?

Colchicine at a low dose Signup and view all the answers

For acute gout limited to one or two joints, which intraarticular administration is recommended?

Triamcinolone hexacetonide 20 to 40 mg Signup and view all the answers

What is the recommended dosage and administration schedule for adrenocorticotropic hormone (ACTH) gel in the treatment of gout?

40 to 80 USP units, intramuscularly every 6 to 8 hours for 2 to 3 days Signup and view all the answers

Under what circumstances should prophylactic treatment for gout be withheld?

If the first episode of acute gouty arthritis was mild, responded promptly to treatment, the serum urate concentration was only minimally elevated, and the 24-hour urinary uric acid excretion was not excessive Signup and view all the answers

Which of the following is a contraindication for the use of ACTH gel in the treatment of gout?

All of the above Signup and view all the answers

What is the recommended duration for the administration of ACTH gel in the treatment of gout?

2 to 3 days, then discontinued Signup and view all the answers

What is the primary purpose of alkalinizing the urine during uricosuric therapy?

To increase the solubility of uric acid, reducing the risk of stone formation Signup and view all the answers

What is the initial recommended dosage of probenecid for uricosuric therapy?

250 mg twice daily Signup and view all the answers

What is the maximum recommended daily dose of probenecid for uricosuric therapy?

2 g/day Signup and view all the answers

What is the initial recommended dosage of sulfinpyrazone for uricosuric therapy?

50 mg twice daily Signup and view all the answers

What is the maximum recommended daily dose of sulfinpyrazone for uricosuric therapy?

800 mg/day Signup and view all the answers

Which of the following is NOT a common side effect associated with uricosuric therapy?

Hepatotoxicity Signup and view all the answers

In which patient population are uricosuric drugs contraindicated?

Patients with impaired renal function Signup and view all the answers

What is the primary mechanism of action of uricosuric drugs in the treatment of hyperuricemia?

Promotion of uric acid excretion through the kidneys Signup and view all the answers

What is the most effective nonpharmacologic therapy for acute gouty arthritis?

Joint rest for 1 to 2 days Signup and view all the answers

When should colchicine ideally be started for an acute gout attack?

Within the first 24 hours Signup and view all the answers

What percentage of patients may experience gastrointestinal adverse effects with oral colchicine?

50% to 80% Signup and view all the answers

Which condition may be worsened in patients taking colchicine along with statins?

Axonal neuromyopathy Signup and view all the answers

Why should colchicine not be used concurrently with macrolide antibiotics?

Elevated plasma colchicine levels Signup and view all the answers

What is the primary benefit of starting colchicine early in the course of an acute gout attack?

Higher likelihood of patient response Signup and view all the answers

Which organ meats are high in purines and should be reduced in the diet for gout patients?

Beef liver Signup and view all the answers

What is the recommended prophylactic treatment for patients with frequent attacks of gouty arthritis?

Colchicine in low oral doses (0.5 to 0.6 mg twice daily) Signup and view all the answers

In patients with renal or hepatic dysfunction, what is the recommended dosage of colchicine for prophylactic treatment?

No more than 0.6 mg daily or every other day Signup and view all the answers

If a patient on prophylactic treatment senses the onset of an acute attack, what is the recommended dosage of colchicine?

1 mg every 2 hours Signup and view all the answers

When can prophylactic treatment for gouty arthritis be discontinued?

After 1 year of normal serum urate concentration and no symptoms Signup and view all the answers

Which drugs are uricosuric agents that increase the renal clearance of uric acid?

Probenecid and sulfinpyrazone Signup and view all the answers

When should uricosuric drugs be used for the treatment of gout?

In patients with underexcretion of uric acid Signup and view all the answers

What is the recommended approach when starting therapy with uricosuric drugs?

Start with a low dose to avoid marked uricosuria and possible stone formation Signup and view all the answers

Which of the following serum uric acid levels or urinary excretion of uric acid would indicate the need for prophylactic treatment?

Serum uric acid greater than 10 mg/dL or 24-hour urinary excretion of uric acid of more than 1,000 mg Signup and view all the answers

What is the primary concern with the use of nonsteroidal antiinflammatory drugs (NSAIDs) in the treatment of rheumatoid arthritis?

They have no impact on disease progression. Signup and view all the answers

Why should corticosteroids seldom be used as monotherapy for rheumatoid arthritis?

They pose the risk of long-term complications. Signup and view all the answers

What adverse effect of methotrexate (MTX) requires monitoring in patients undergoing treatment for rheumatoid arthritis?

Gastrointestinal toxicities Signup and view all the answers

Which combination is considered particularly effective in the treatment of rheumatoid arthritis?

MTX plus cyclosporine Signup and view all the answers

Which property of methotrexate (MTX) contributes to its antiinflammatory effects in the treatment of rheumatoid arthritis?

Inhibition of purine biosynthesis Signup and view all the answers

Why are nonsteroidal antiinflammatory drugs (NSAIDs) used for symptomatic relief in rheumatoid arthritis?

To provide rapid improvement compared to DMARDs Signup and view all the answers

What role does folic acid play in the treatment of methotrexate (MTX) toxicity during rheumatoid arthritis therapy?

It reduces some adverse effects without loss of efficacy. Signup and view all the answers

What distinguishes corticosteroids from disease-modifying antirheumatic drugs (DMARDs) in their treatment approach for rheumatoid arthritis?

DMARDs target disease progression while corticosteroids offer rapid symptom relief. Signup and view all the answers

Which of the following is NOT a recommended first-line disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis?

Azathioprine Signup and view all the answers

What is the primary benefit of using biologic agents for the treatment of rheumatoid arthritis?

Ability to treat patients who have failed treatment with other DMARDs Signup and view all the answers

What is the primary mechanism of action of uricosuric drugs in the treatment of hyperuricemia?

Increasing the renal clearance of uric acid Signup and view all the answers

Which of the following is a potential serious adverse effect associated with intravenous administration of colchicine?

Bone marrow suppression Signup and view all the answers

What is the primary purpose of alkalinizing the urine during uricosuric therapy for the treatment of gout?

To increase the solubility of uric acid in the urine Signup and view all the answers

Which of the following is NOT a recommended nonpharmacologic therapy for the management of rheumatoid arthritis?

Corticosteroid injections Signup and view all the answers

Assisst. Prof. Hassan Khuder Rajab 2nd Class - Gouty Arthritis

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Questions and Answers

What is the recommended initial oral dose of colchicine for acute attacks of gouty arthritis?

Why should IV colchicine be avoided?

How should the initial IV dose of colchicine be administered?

After completing a full IV course of colchicine, how long should patients wait before receiving colchicine by any route?

In what situations are corticosteroids primarily reserved for the treatment of acute gouty arthritis attacks?

What is the recommended dose of prednisone for treating acute attacks of gouty arthritis?

Why are corticosteroids also used in patients with multiple-joint involvement in gouty arthritis?

What is a potential serious adverse effect associated with IV colchicine administration?

What is the recommended approach for tapering the dose of corticosteroids to avoid rebound attacks?

Which route of administration can be used as an alternative to oral corticosteroids if patients are unable to take oral therapy?

What adjunctive therapy can be used with injectable corticosteroids to prevent rebound flare-ups, if not contraindicated?

For acute gout limited to one or two joints, which intraarticular administration is recommended?

What is the recommended dosage and administration schedule for adrenocorticotropic hormone (ACTH) gel in the treatment of gout?

Under what circumstances should prophylactic treatment for gout be withheld?

Which of the following is a contraindication for the use of ACTH gel in the treatment of gout?

What is the recommended duration for the administration of ACTH gel in the treatment of gout?

What is the primary purpose of alkalinizing the urine during uricosuric therapy?

What is the initial recommended dosage of probenecid for uricosuric therapy?

What is the maximum recommended daily dose of probenecid for uricosuric therapy?

What is the initial recommended dosage of sulfinpyrazone for uricosuric therapy?

What is the maximum recommended daily dose of sulfinpyrazone for uricosuric therapy?

Which of the following is NOT a common side effect associated with uricosuric therapy?

In which patient population are uricosuric drugs contraindicated?

What is the primary mechanism of action of uricosuric drugs in the treatment of hyperuricemia?

What is the most effective nonpharmacologic therapy for acute gouty arthritis?

When should colchicine ideally be started for an acute gout attack?

What percentage of patients may experience gastrointestinal adverse effects with oral colchicine?

Which condition may be worsened in patients taking colchicine along with statins?

Why should colchicine not be used concurrently with macrolide antibiotics?

What is the primary benefit of starting colchicine early in the course of an acute gout attack?

Which organ meats are high in purines and should be reduced in the diet for gout patients?

What is the recommended prophylactic treatment for patients with frequent attacks of gouty arthritis?

In patients with renal or hepatic dysfunction, what is the recommended dosage of colchicine for prophylactic treatment?

If a patient on prophylactic treatment senses the onset of an acute attack, what is the recommended dosage of colchicine?

When can prophylactic treatment for gouty arthritis be discontinued?

Which drugs are uricosuric agents that increase the renal clearance of uric acid?

When should uricosuric drugs be used for the treatment of gout?

What is the recommended approach when starting therapy with uricosuric drugs?

Which of the following serum uric acid levels or urinary excretion of uric acid would indicate the need for prophylactic treatment?

What is the primary concern with the use of nonsteroidal antiinflammatory drugs (NSAIDs) in the treatment of rheumatoid arthritis?

Why should corticosteroids seldom be used as monotherapy for rheumatoid arthritis?

What adverse effect of methotrexate (MTX) requires monitoring in patients undergoing treatment for rheumatoid arthritis?

Which combination is considered particularly effective in the treatment of rheumatoid arthritis?

Which property of methotrexate (MTX) contributes to its antiinflammatory effects in the treatment of rheumatoid arthritis?

Why are nonsteroidal antiinflammatory drugs (NSAIDs) used for symptomatic relief in rheumatoid arthritis?

What role does folic acid play in the treatment of methotrexate (MTX) toxicity during rheumatoid arthritis therapy?

What distinguishes corticosteroids from disease-modifying antirheumatic drugs (DMARDs) in their treatment approach for rheumatoid arthritis?

Which of the following is NOT a recommended first-line disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis?

What is the primary benefit of using biologic agents for the treatment of rheumatoid arthritis?

What is the primary mechanism of action of uricosuric drugs in the treatment of hyperuricemia?

Which of the following is a potential serious adverse effect associated with intravenous administration of colchicine?

What is the primary purpose of alkalinizing the urine during uricosuric therapy for the treatment of gout?

Which of the following is NOT a recommended nonpharmacologic therapy for the management of rheumatoid arthritis?

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