What rheumatologic illnesses are more common in men?
Gout, spondyloarthopathy, nongonococcal arthritis
What level of WBCs is normal in a joint?
<200. >50,000 is assumed to be infected.
What is a type I hypersensitivity reaction?
immediate hypersensitivity disorders
What is a type II Hypersensitivity disorder?
What is a type III hypersensitivity disorder?
immune complex mediated disorder (what RA is)
What is a type IV hypersensitivity disorder?
T-cell mediated disorder (like PPD)
Uric acid is the end product of____
What are the 4 ways that gout can result from?
1. overproduction of purines
2. decrease salvage of free purine bases
3. changin breakdown of nucleic acids and increase cell turnover
4. decrease urinary excretion (primary and most common 90%)
What type of areas does gout tend to precipitate in?
cooler areas of the body, like the big toe.
What type of formation is eventually formed after 10 years of having the first gout attack?
Tophi formation (called chronic tochaceous gout at that point)
What is typical treatment for gout?
Acute attack: Colchicine, NSAIDS, steroids
Rx the uric acid: Allopurinol, probenecid.
Indomethacin in a young person works great! NSAIDS but not chronically. Colchicine can be used for acute attacks if used early and can also be used prophylactically, high dose aspirin for pain, steroids, ACTH
What is the gold standard for diagnosing gout?
Synovial fluid analysis to see cystals in the fluid.
At what level of uric acid in your body will you start crystalizing?
What is uric acid levels also a marker for? (what syndrome)
If someone is a profound overproducer of uric acid, what med do you NEVER want to give them?
What is psuedogout commonly associated with? (in severe disease)
OA. Cartilage degeneration occurs with shedding pyrophosphate crytals into joint cavity (old age)