gout

gout

1. Classification and staging

2. Gout Chronic Disease- in 4 Stages (natural history)

3. Risk factors

   • Alcohol... Diet... Genetics... Gender... Age... Medications... Obesity... Medical
     • Alcohol and gout
       • inhibit uric acid secretion and increase urate production

4. Causes of Gout

   • • Causes of Increased Source or Production
       • Causes of Increased Source or Production
         • Consumption
           • Anchovies, sardines, kidney, liver, and red-meat, fructose-sweetened drinks
         • Cell lysis & turnover
           • myeloproliferative & lymphoproliferative disorders
         • Genetic disorders:
           • HGPRT deficiency (Lesch-Nyhan syndrome) G6PD (von Gierke disease)
       • Causes of Decreased Elimination
         • Renal insufficiency or Medullary cystic KD
           • Thiazide diuretics, Niacin, Aspirin, Cyclosporine, Pembrolizumab
             • GLUT9 gene ↔ Solute Carrier 2A9 (SLC2A9) [↑ reabsorption of urate]

5. What about causes of Pseudogout?

   • Hyperparathyroidism Hemochromatosis Etidronate disodium therapy Angiography

6. Signs & symptoms

   • Podagra... Tophi... Swollen inflamed joint... Limited ROM

7. Complications of gout

8. Treatment

   • Acute gouty arthritis
     • NSAIDs Corticosteroids Colchicine
   • Hyperuricemia in gout
     • Allopurinol

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