Pharmacy Quiz: Management of Gout

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What is the usual maintenance dose of febuxostat?

100-200 mg/day

250-300 mg/day

800-900 mg/day

> 300 mg/day (correct)

What is the recommended hydration level to prevent kidney stones when taking probenecid?

> 2L of water (correct)

No specific hydration level is recommended

> 1L of water

> 3L of water

What is the primary goal of HLA-B*5801 genotyping before initiating allopurinol?

To rule out other underlying conditions

To identify risk of allopurinol-induced SCARs (correct)

To predict treatment response

To determine optimal dosing

What is the initial dose of probenecid for patients with gout?

250 mg BD x 1 week Signup and view all the answers

What is the maximum dose of febuxostat in patients with normal renal function?

800-900 mg/day Signup and view all the answers

What is the time frame in which severe cutaneous adverse reactions (SCARs) most commonly occur after initiating allopurinol?

Within the first few weeks to months Signup and view all the answers

What is the primary cause of over-production of uric acid?

Inborn errors of metabolism Signup and view all the answers

A patient wakes up with severe pain in the big toe joint. What is the likely diagnosis?

Gout Signup and view all the answers

What is the diagnostic test for gout?

Presence of uric acid crystals in joint aspirate Signup and view all the answers

What is the goal of treatment in gout?

All of the above Signup and view all the answers

What is the normal serum uric acid level in women?

> 6 mg/dL Signup and view all the answers

What is the treatment target for urate lowering therapy in tophaceous gout?

< 300 μmol/L Signup and view all the answers

What is the name of the enzyme that breaks down hypoxanthine and guanine to form nucleic acids?

Hypoxanthine-guanine phosphoribosyltransferase Signup and view all the answers

What is the purpose of prophylaxis in gout management?

To reduce the risk of future attacks Signup and view all the answers

What is the name of the crystal that is deposited in the joints of patients with gout?

Monosodium urate Signup and view all the answers

What is the term for the period between gout flares?

Inter-critical phase Signup and view all the answers

What is the reason routine genotyping is not done for allopurinol-induced SCAR?

Lack of alternative cost-effective ULT options and low positive predictive value Signup and view all the answers

Which of the following medications increases the risk of bone marrow suppression when used with allopurinol?

Azathioprine Signup and view all the answers

What is the purpose of initiating ULT with anti-inflammatory prophylaxis when starting allopurinol?

To prevent acute gout flares Signup and view all the answers

Which of the following is NOT a drug interaction with allopurinol?

Pegloticase Signup and view all the answers

What is the typical dose of colchicine used for prophylaxis against acute flares when starting allopurinol?

0.5 mg OD Signup and view all the answers

Which of the following patient groups is at higher risk of allopurinol-induced SCAR?

Patients with renal impairment Signup and view all the answers

What is the recommended action when considering alternative antihypertensive therapy for gout patients?

Replace HCTZ with an ACE inhibitor like enalapril Signup and view all the answers

Which type of medication has a uricosuric effect and can be considered for gout patients?

Losartan and ACE inhibitors Signup and view all the answers

What should not be stopped or modified in gout patients despite its anti-uricosuric effect?

Low-dose aspirin therapy Signup and view all the answers

Which food-related information is relevant for gout patients?

Total purine and purine base content of common foodstuffs Signup and view all the answers

What is an important aspect to consider when taking a patient's medical history for gout?

The timing and severity of the patient's symptoms Signup and view all the answers

What is a recommended question to ask a patient during a gout consultation?

Can you describe the pain and trauma to your toe? Signup and view all the answers

What is the primary underlying cause of gout?

Imbalances in purine metabolism leading to uric acid accumulation Signup and view all the answers

What is the term for the deposition of monosodium urate crystals in articular and periarticular tissues?

Podagra Signup and view all the answers

What is the goal of pharmacotherapy in managing gout?