Gout, Pseudogout
Ch 167
Ch 167
Treatment for asymptomatic hyperuricemia
As only ∼5% of hyperuricemic pts develop gout, treatment of asymptomatic hyperuricemia is not indicated.
Exceptions are pts about to receive cytotoxic therapy for neoplasms.
Treatment of polymyalgia rheumatica
(drug AND dose)
Prednisone 10-20 mg daily
Patients have rapid improvement but may require treatment for months to years.
Sarcoidosis is characterized by the presence of what?
noncaseating granulomas of unknown etiology
Amyloidosis is characterized by the extracellular deposition of what?
insoluble polymeric protein fibrils
What states make up the four corners?
Colorado
Utah
Arizona
New Mexico
Name three diseases associated with pseudogout
Primary hyperparathyroidism
Hemochromatosis
Hypophosphatasia
Hypomagnesemia
Chronic gout
Postmeniscectomy
Gitelman’s syndrome
How is relapsing polychondritis diagnosed?
Clinically
Can confirm with biopsy of affected cartilage
Cause of sarcoidosis
The cause of sarcoidosis is unknown, and current evidence suggests that the triggering of an inflammatory response by an unidentified antigen in a genetically susceptible host is involved.
Leading cause of death in amyloidosis
Cardiac involvement
Prognosis: Outcome is variable and depends on type of amyloidosis and organ involvement. Average survival of AL amyloid without treatment is ∼1–2 years; cardiac involvement is the leading cause of death with a median survival of ∼6 months without treatment.
What is the longest suspension bridge between anchorages in the Western Hemisphere?
Mackinac Bridge
Initiating uric acid lowering agents can precipitate an acute gout flare. Concomitant oral colchicine 0.6 mg daily should be considered until the uric acid level is less than ___.
6.0 mg/dl
Hypertrophic osteoarthropathy is most commonly seen in association with what?
Lung carcinoma
Management of sarcoidosis when patients are symptomatic with multiple organs involved
Glucocorticoids
Most common form of localized amyloidosis
Aβ found in Alzheimer’s disease derived from abnormal proteolytic processing of the amyloid precursor protein
When aging in barrels, 2-5% per year per barrel of whiskey is lost. What is this called?
The angel's share
Definitively identifying calcium apatite deposition disease requires what?
Electron microscopy or xray diffraction studies
Calcific tendinitis results from deposition of primarily which calcium salt?
Hydroxyapatite
In what percentage of patients with sarcoidosis does remission occur?
>50% within 2-5 years
Sarcoidosis is usually a selflimited, nonlifethreatening disease. Remission occurs in >50% within 2–5 years of diagnosis with at least 20% developing chronic diseases.
Most common form of systemic amyloidosis
AL (immunoglobulin light chains): primary amyloidosis; most common form of systemic amyloidosis; arises from a clonal Bcell disorder, usually multiple myeloma.
What is the national animal of Scotland?
Unicorn
What treatments can be used when other treatments for acute gouty arthritis have failed or were contraindicated?
Anakinra, canakinumab (inhibitors of interleukin1β)
Pregabalin, duloxetine, and ______ have shown benefit for fibromyalgia.
milnacipran
Name 3 alternative therapies for treatment of chronic disease when glucocorticoids are not tolerated
Methotrexate
Hydroxychloroquine
Azathioprine
Leflunomide
Mycophenolate
Minocycline
Diagnosis relies on the identification of fibrillar deposits in tissues and typing of the amyloid. _______ will demonstrate amyloid deposits in >80% of pts with systemic amyloid.
Congo red staining of abdominal fat
What is Earth's circumference?
24,900 miles