29 Questions
What is the PRIMARY objective of the lecture given by Assist.prof.HASSAN KHUDER RAJAB?
To discuss all aspects of gout, including definition, acute attack treatment, prophylaxis, and evaluation of treatment
What is the MAIN non-pharmacological therapy recommended for patients with acute gouty arthritis?
A combination of reducing high-purine foods, increasing fluid intake, applying ice, and resting the joint
When is colchicine most effective in relieving acute gout attacks?
When started within the first 24 hours of symptom onset
What is the MAIN adverse effect associated with oral colchicine use?
GI adverse effects (nausea, vomiting, diarrhea)
What is the MAIN contraindication for concurrent use of colchicine and macrolide antibiotics?
Increased plasma colchicine levels and agranulocytosis
Which of the following is a NON-GI adverse effect associated with colchicine use?
Neutropenia and axonal neuromyopathy
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)
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
When should uricosuric drugs such as probenecid and sulfinpyrazone be used?
They should only be used in patients with documented underexcretion of uric acid
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
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)
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
What is the recommended initial daily dose of probenecid?
250 mg twice daily
How often should the daily dose of sulfinpyrazone be increased during therapy?
100-mg increments each week
What is the maximum recommended daily dose of probenecid?
2 g/day
What are the major side effects associated with uricosuric therapy?
GI irritation and rash
In which patients are probenecid and sulfinpyrazone contraindicated?
Patients who are allergic to them and patients with impaired renal function
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
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
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
If a patient receives a full IV course of colchicine, how long should they wait before receiving colchicine by any route?
7 days
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
What is the recommended dose and duration of corticosteroid therapy for acute gout attacks?
Prednisone 30-60 mg once daily for 3-5 days
What is the recommended duration for gradually tapering the dose of steroids during withdrawal?
10-14 days
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
What is the recommended dosage range for ACTH gel administration?
40-80 USP units every 6-8 hours
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)
Which of the following is recommended as adjunctive therapy to injectable corticosteroids to prevent rebound flare-ups?
Low-dose colchicine
What is the recommended dosage range for intraarticular administration of triamcinolone hexacetonide for acute gout limited to one or two joints?
20-40 mg
Test your knowledge on the treatment objectives for gouty arthritis, including the definition of gout, acute attack treatment, prophylaxis therapy, and evaluation methods. Questions cover nonpharmacologic therapies like dietary changes, joint rest, and more.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
