Term
|
Definition
| end product of purine degradation |
|
|
Term
|
Definition
| enzyme involved in purine metabolism |
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|
Term
|
Definition
| near the limits of solubility |
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|
Term
|
Definition
| 1200 mg accumulated uric acid |
|
|
Term
|
Definition
| 600 mg accumulated uric acid |
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|
Term
|
Definition
| urate pool is increased several fold |
|
|
Term
| uric acid (keto form) goes to uric acid (enol form) |
|
Definition
| hydrogen removed to form URATE |
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|
Term
|
Definition
| forms crystal and precipitates at LOW pH |
|
|
Term
|
Definition
| forms crystal and precipitates at physiologic or HIGH pH |
|
|
Term
| increased prevalence due to |
|
Definition
| dietary habits, increasing logevity, increasing prevalence of obesity and metabolic syndrome |
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|
Term
|
Definition
| during middle age and is uncommon before 30 years of age |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| of uric acid is excreted by the kidneys, the rest excreted by GI tract |
|
|
Term
| uric acid is filtered through |
|
Definition
| glomeruli, then reabsorbed in the proximal tubule and secreted distally |
|
|
Term
| 5 year cumulative risk of gout |
|
Definition
| 0.6% with serum urate <7mg/dl, 30.5% with serum urate >10mg/dl |
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|
Term
|
Definition
|
|
Term
| it is more rare for patients |
|
Definition
| 40-44years and even less so for ages 50-64 years |
|
|
Term
|
Definition
|
|
Term
| normal production considered to be |
|
Definition
|
|
Term
|
Definition
| may result in an abnormality in the enzymes that regulate purine metabolism |
|
|
Term
| patient on a regular diet who excrets more than 800 mg of uric acid in 24 hours is considered |
|
Definition
|
|
Term
| increased risk in those with a diet of high |
|
Definition
| intake of purines, alcohol, sofdrinks and fructose |
|
|
Term
| decreased risk in those with a large consumption of |
|
Definition
| coffee, dairy products, and vitamin C |
|
|
Term
| increased risk with those who are taking |
|
Definition
| thiazide diuretics, low does aspirin, cyclosporin |
|
|
Term
| increased risk in those who have |
|
Definition
| insulin resistance, metabolic syndroe, obesity, renal insufficiency and HTN |
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|
Term
|
Definition
| Recurrent attacks of acute arthritis associated with monosodium urate crystals in synovial fluid. |
|
|
Term
|
Definition
| usually monoarthic (in one joint) |
|
|
Term
|
Definition
|
|
Term
| over 50% of initial attacks occur in |
|
Definition
|
|
Term
| acute gouty arthritis resolves without intervention |
|
Definition
|
|
Term
| crystals of _______ are deposited in and around synovial fluid |
|
Definition
| monosodium urate crystals |
|
|
Term
|
Definition
| ingest crystals and release vesicals leading to inflammation of the joind |
|
|
Term
| changes in serum uric acid concentration |
|
Definition
|
|
Term
| attacks usually occur at night due to |
|
Definition
| not exercising joints and not getting fresh synovial effusions |
|
|
Term
| attacks often occur in lower extremities |
|
Definition
| lower temp and decreased urate solubility |
|
|
Term
|
Definition
| Time after acute attack has resolved or time between attacks |
|
|
Term
|
Definition
| late complication of hyperuricemia (about 12 years after initial attack |
|
|
Term
|
Definition
| nodular deposits of monosodium urate crystals in the tissues in and around the joints |
|
|
Term
| occur on the great toe, fingers, knees and other places |
|
Definition
| trophi that lead to soft tissue damage, deformity, joint destruction and nerve compression |
|
|
Term
| treatment goal for acute gouty arthritis |
|
Definition
| terminate acute attack, prevent terminate recurrent attacks, prevent complications associate with urate crystal deposition |
|
|
Term
| treatment option for acute gouty arthritis |
|
Definition
| nonpharmacologic, NSAIDs, Colchicine, steroids |
|
|
Term
|
Definition
| reduce intake of saturated fats, meats high in protein, salt and increase fluid intake, rest joints for 1-2 days, ice (NO HEAT), weight loss, avoid thiazide diuretics |
|
|
Term
| recurrent gouty arthritis |
|
Definition
| treat if suffering from 2 or more attacks per year |
|
|
Term
|
Definition
|
|
Term
| drug of choice for recurrent gouty arthritis |
|
Definition
| allopurinol; do not initiate during acute attacks, wait 2-4 weeks |
|
|
Term
| uric acid nephrolithiasis |
|
Definition
| kidney stones caused by uric acid deposits; Solubility of uric acid decreases in acidic environments – stones can form. |
|
|
Term
|
Definition
| The blockage of urine flow from nephrolithiasis (the kidney stones) in the collecting ducts and ureters can lead to acute renal failure |
|
|
Term
| chronic gouty nephropathy |
|
Definition
| Long-term deposition of crystals in the nephron; Microtophi cause cell inflammation |
|
|
Term
| rapid lowering of urate levels |
|
Definition
| associated with gout flares; possibly due to urate stores mobilized when levels fall |
|
|
Term
| gout flare prophylaxis (without trophus) |
|
Definition
| colchicine 0.6mg BID or QD if no diarrhea for 6 months |
|
|
Term
| gout flare prophylaxis (with trophi) |
|
Definition
| colchicine 0.6mg BID or QD if no diarrhea for 6 months or until tophus resolves |
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