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gout

Classification and staging
GoutChronic Disease- in 4 Stages (natural history)
Risk factors
1. Alcohol... Diet... Genetics... Gender... Age... Medications... Obesity... Medical
  1. Alcohol and gout
    1. inhibit uric acid secretion and increase urate production
Causes of Gout
1. 1. Causes of Increased Source or Production
    1. Causes of Increased Source or Production
      1. Consumption
        Anchovies, sardines, kidney, liver, and red-meat, fructose-sweetened drinks
      2. Cell lysis & turnover
        myeloproliferative & lymphoproliferative disorders
      3. Genetic disorders:
        HGPRT deficiency (Lesch-Nyhan syndrome) G6PD (von Gierke disease)
    2. Causes of Decreased Elimination
      1. Renal insufficiency or Medullary cystic KD
        Thiazide diuretics, Niacin, Aspirin, Cyclosporine, Pembrolizumab
        GLUT9 gene ↔ Solute Carrier 2A9 (SLC2A9) [↑ reabsorption of urate]
What about causes of Pseudogout?
1. Hyperparathyroidism Hemochromatosis Etidronate disodium therapy Angiography
Signs & symptoms
1. Podagra... Tophi... Swollen inflamed joint... Limited ROM
Complications of gout
Treatment
1. Acute gouty arthritis
  1. NSAIDs Corticosteroids Colchicine
2. Hyperuricemia in gout
  1. Allopurinol

gout

	Criado por daliya ahmed quase 7 anos atrás