Gouty Arthritis Treatment Objectives Quiz

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What is the PRIMARY objective of the lecture given by Assist.prof.HASSAN KHUDER RAJAB?

To define gout and discuss its treatment
To discuss the prophylaxis of gout therapy
To evaluate the treatment of gout
To discuss all aspects of gout, including definition, acute attack treatment, prophylaxis, and evaluation of treatment (correct)

What is the MAIN non-pharmacological therapy recommended for patients with acute gouty arthritis?

Reducing intake of high-purine foods and increasing fluid intake
Losing weight if obese
Applying local ice and resting the joint
A combination of reducing high-purine foods, increasing fluid intake, applying ice, and resting the joint (correct)

When is colchicine most effective in relieving acute gout attacks?

When started within the first 72 hours of symptom onset
When started within the first 48 hours of symptom onset
When started within the first 12 hours of symptom onset
When started within the first 24 hours of symptom onset (correct)

What is the MAIN adverse effect associated with oral colchicine use?

GI adverse effects (nausea, vomiting, diarrhea) (D) Signup and view all the answers

What is the MAIN contraindication for concurrent use of colchicine and macrolide antibiotics?

Increased plasma colchicine levels and agranulocytosis (C) Signup and view all the answers

Which of the following is a NON-GI adverse effect associated with colchicine use?

Neutropenia and axonal neuromyopathy (B) 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) (B) Signup and view all the answers

What is the recommended dose adjustment for colchicine in patients with renal or hepatic dysfunction?

The oral dose should be reduced to no more than 0.6 mg daily or every other day (C) Signup and view all the answers

When should uricosuric drugs such as probenecid and sulfinpyrazone be used?

They should only be used in patients with documented underexcretion of uric acid (D) Signup and view all the answers

What is the recommended approach to discontinuing prophylactic treatment for gout?

Prophylactic treatment may be attempted to be discontinued if the serum urate concentration remains normal and the patient is symptom-free for 1 year (D) Signup and view all the answers

What is the recommended approach to treating an acute attack of gouty arthritis in a patient receiving prophylactic colchicine?

Continue prophylactic colchicine and treat the acute attack with high-dose colchicine (1 mg every 2 hours) (C) Signup and view all the answers

What is the recommended approach to starting uricosuric drug therapy for gout?

Uricosuric drugs should be started at a low dose to avoid marked uricosuria and possible stone formation (C) Signup and view all the answers

What is the recommended initial daily dose of probenecid?

250 mg twice daily (D) Signup and view all the answers

How often should the daily dose of sulfinpyrazone be increased during therapy?

100-mg increments each week (B) Signup and view all the answers

What is the maximum recommended daily dose of probenecid?

2 g/day (C) Signup and view all the answers

What are the major side effects associated with uricosuric therapy?

GI irritation and rash (D) Signup and view all the answers

In which patients are probenecid and sulfinpyrazone contraindicated?

Patients who are allergic to them and patients with impaired renal function (D) Signup and view all the answers

Which statement about colchicine dosing for acute gout attacks is correct?

The initial oral dose is 1 mg, followed by 0.5 mg every hour until symptoms subside or a maximum of 8 mg is reached (A) Signup and view all the answers

Which statement regarding the use of IV colchicine is true?

It should be avoided due to the risk of serious adverse effects like bone marrow suppression and tissue necrosis (D) Signup and view all the answers

What is the recommended initial IV dose of colchicine, if considered necessary?

2 mg diluted in 10-20 mL of normal saline, administered over 10-20 minutes (A) Signup and view all the answers

If a patient receives a full IV course of colchicine, how long should they wait before receiving colchicine by any route?

7 days (A) Signup and view all the answers

Which statement about the use of corticosteroids in acute gout attacks is correct?

They are recommended for patients with contraindications or non-response to NSAIDs or colchicine (D) Signup and view all the answers

What is the recommended dose and duration of corticosteroid therapy for acute gout attacks?

Prednisone 30-60 mg once daily for 3-5 days (D) Signup and view all the answers

What is the recommended duration for gradually tapering the dose of steroids during withdrawal?

10-14 days (D) Signup and view all the answers

Which of the following is a recommended alternative to oral steroid therapy if patients are unable to take oral medication?

A single intramuscular injection of a long-acting corticosteroid (C) Signup and view all the answers

What is the recommended dosage range for ACTH gel administration?

40-80 USP units every 6-8 hours (A) Signup and view all the answers

When can prophylactic treatment for gout be withheld, according to the text?

If the first episode of acute gouty arthritis was mild and responded promptly to treatment, the patient's serum urate concentration was only minimally elevated, and the 24-hour urinary uric acid excretion was not excessive (less than 1,000 mg/24 hours on a regular diet) (C) Signup and view all the answers

Which of the following is recommended as adjunctive therapy to injectable corticosteroids to prevent rebound flare-ups?

Low-dose colchicine (A) Signup and view all the answers

What is the recommended dosage range for intraarticular administration of triamcinolone hexacetonide for acute gout limited to one or two joints?

20-40 mg (D) Signup and view all the answers