Understanding Gout and Uric Acid Metabolism

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Questions and Answers

Which symptom is most characteristic of an acute gout attack?

Strange lumps around joints

Kidney stones

Rapidly worsening pain (correct)

Pain in the elbows

Which dietary component is primarily involved in the biosynthesis of uric acid?

Guanine

Cytosine

Adenine

Hypoxanthine (correct)

What is the relationship between diuretics and hyperuricemia?

Diuretics induce hyperuricemia by increasing urate reabsorption (correct)

Diuretics do not affect uric acid levels

Diuretics lower serum uric acid levels

Diuretics decrease urate reabsorption

Which test is utilized to detect the presence of crystals in the joint fluid for gout diagnosis?

Joint aspiration and polarized light microscopy Signup and view all the answers

Which condition is associated with an increased risk for developing gout due to high cell turnover?

Psoriasis Signup and view all the answers

What does a high erythrocyte sedimentation rate indicate in the context of gout?

Possible presence of inflammation Signup and view all the answers

Which demographic group is more predisposed to gout?

Older men Signup and view all the answers

What does the presence of tophi around joints indicate?

Chronic gout Signup and view all the answers

What serum uric acid level is generally considered elevated?

More than 10 mg/l Signup and view all the answers

Which of the following tests may show normal results during an acute gout attack?

X-ray Signup and view all the answers

What is the primary goal of targeting serum uric acid levels in gout management?

To help alleviate symptoms and prevent future attacks Signup and view all the answers

Why should aspirin be avoided in the treatment of gout?

It alters uric acid levels and may intensify an acute attack Signup and view all the answers

What is the mechanism of action of colchicine in treating gout?

Blocks neutrophil migration and reduces inflammatory glycoprotein production Signup and view all the answers

Which dietary practice is recommended for managing gout?

Increased consumption of skimmed milk and unsaturated fats Signup and view all the answers

What is a significant concern when using colchicine in patients with renal insufficiency?

Increased serum uric acid levels due to lower drug clearance Signup and view all the answers

Which COX-2 inhibitor is suggested for patients unable to tolerate conventional NSAIDs?

Etoricoxib Signup and view all the answers

What defines the therapeutic index of colchicine?

It has a narrow therapeutic index, increasing the risk of toxicity Signup and view all the answers

What mechanism does allopurinol use to lower uric acid levels in the body?

Inhibits xanthine oxidase, decreasing uric acid formation Signup and view all the answers

What is a common initial sign of colchicine toxicity?

Gastrointestinal intolerance like diarrhea or nausea Signup and view all the answers

What is the recommended lifestyle change for obese patients with gout?

Implement weight loss strategies to lower gout risk Signup and view all the answers

Which statement about allopurinol is correct?

Its use may lead to Steven Johnson syndrome in the initial months of treatment. Signup and view all the answers

What is a contraindication when prescribing febuxostat?

Use in patients with ongoing chemotherapy. Signup and view all the answers

What is a significant risk associated with uricosuric agents?

They expose patients to a risk of uric acid stones, especially at treatment onset. Signup and view all the answers

Which of the following is true regarding lesinurad?

Lesinurad acts as a uricosuric agent by inhibiting URAT1. Signup and view all the answers

What are the potential side effects of febuxostat?

Nausea, vomiting, joint stiffness, and headaches. Signup and view all the answers

Which pathway is associated with the pathogenesis of gouty arthritis?

ATP signaling through P2X7R receptors. Signup and view all the answers

What is the effect of allopurinol on uric acid?

It inhibits the metabolism of purines, thus reducing uric acid levels. Signup and view all the answers

Which of the following is a common reason for caution when prescribing febuxostat?

Increased risk of cardiovascular side effects compared to allopurinol. Signup and view all the answers

How should uricosuric agents be used in patients with a history of uric acid stones?

They should be avoided as monotherapy. Signup and view all the answers

What distinguishes febuxostat from allopurinol?

Febuxostat does not require renal adjustment in moderate renal failure. Signup and view all the answers

Study Notes

Gout

Gout is a condition where excess uric acid crystals accumulate in joints, causing pain and inflammation.
Symptoms include intense joint pain, redness, swelling, and tenderness.
Uric acid is a byproduct of purine metabolism.
High levels of serum uric acid (greater than 10mg/L) are not always indicative of gout.
Normal serum uric acid levels are less than 7 mg/L
Diagnosis involves joint aspiration and light microscopy to detect crystals.
Full blood count with elevated white blood cells typically indicates inflammation.
Erythrocyte sedimentation rate helps assess inflammation; a faster-than-normal rate suggests inflammation.
X-ray can show signs of acute gout (e.g., joint inflammation).

Uric Acid Biosynthesis

Uric acid is formed from dietary intake and purine bases and cell breakdown.
Hypoxanthine is a precursor in the process.
Xanthine oxidase is an enzyme that converts hypoxanthine to xanthine and then to uric acid.
Uric acid is excreted by the kidneys.

Predisposition

Males are more susceptible than females to gout.
Family history increases the risk.
Body size (larger) increases risk.
Diet high in purines increases risk.
Alcohol consumption is a risk factor.
Diuretics can cause hyperuricemia.
Diseases/treatments that cause high cell turnover (e.g., psoriasis, chemotherapy) can contribute.
Impaired renal function increases the risk of gout.

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Description

This quiz explores the condition of gout, its symptoms, and the role of uric acid in the body. It covers key diagnostic methods and the biosynthesis of uric acid from purine metabolism. Test your knowledge on these interrelated topics and understand their implications on health.