Crystal Associated Arthropathies (Msq Drill 153)

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  • 1/53 Questions

    Under polarized microscopy gout crystals will look:

    • Needle shaped
    • Round shaped
    • Rhomboid shaped
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  • 2. 

    Gout is basically hyperuricemia. How can hyperuricemia come about?

    • Increased production only

    • Decreased excretion only

    • Both increased production and decreased secretion

    Correct Answer
    A. Both increased production and decreased secretion
  • 3. 

    Uric acid levels confirm a diagnosis of gout. True or false?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    A patient may have asymptomatic hyperuricemia that does not need to be treated.

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  • 4. 

    Which of the following are other drugs and toxins that can lead to UNDEREXCRETION of uric acid therefore hyperuricemia?

    • Diuretics esp HCTZ

    • Ethanol

    • Cyclosporine A

    • Pyrazinaide

    • Lead neprhopathy

    Correct Answer(s)
    A. Diuretics esp HCTZ
    A. Ethanol
    A. Cyclosporine A
    A. Pyrazinaide
    A. Lead neprhopathy
  • 5. 

    After monopause, does the incidence of gout in women increase?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 6. 

    Which stage of gout is characterized by tophaceous nodules?

    • Asympatomatic

    • Acute

    • Chronic

    Correct Answer
    A. Chronic
  • 7. 

    In females the same adult levels are reached at:

    • Puberty

    • Later adolescents

    • Menopause

    Correct Answer
    A. Menopause
  • 8. 

    The vast majority of patients with hyperuricemia do hot have symptoms. True or false?

    • True

    • False

    Correct Answer
    A. True
    Explanation
    You do not have to treat asymptomatic pts with hyperuricemia.

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  • 9. 

    Is gout usually monoarticular or polyarticular?

    • Monoarticular

    • Polyarticular

    Correct Answer
    A. Monoarticular
  • 10. 

    Does the gouty arthritis usually subside on it own?

    • Yes in about 3-10 days

    • No, it will need to be treated in order for it to subside in 3-10 days

    Correct Answer
    A. Yes in about 3-10 days
  • 11. 

    So, urate crystals will be present in synovial fluid?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 12. 

    If you have multiple intermittent attacks of acute gout, you can eventually develop tophi anywhere over the body. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 13. 

    Because allopurinol can make gout worse, it should only be taken when the acute episode is over, rather acute treatment should be initiated with "other" drugs. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 14. 

    Is there a strong familial link to gout?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 15. 

    In other words patients who have had a transplant and are taking cyclosporine will have rapid development of tophi. true or false?

    • True

    • False

    Correct Answer
    A. True
  • 16. 

    So psuedogout is:

    • Monosodium urate monohydrate

    • Calcium pyrophosphate dihydrate

    • Calcium oxalate

    • Calcium phosphate

    Correct Answer
    A. Calcium pyrophosphate dihydrate
    Explanation
    other causes for calcium pyrophosphate dihydrate crystals are asymptomatic chondroclacinosis and chronic arthropathy.

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  • 17. 

    So, basically you should use allopurino, probenecid and uloric to treat chornic gout after stabilization by acute meds. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 18. 

    Psuedogout is caused by calcium pyrophosphate dihydrate crystals. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 19. 

    Initial attack of gout in 75% of patients is in the:

    • 1st MCP

    • 2nd MTP

    • 3rd MCP

    • 1st MTP

    Correct Answer
    A. 1st MTP
  • 20. 

    Does the joint fluid show an inflammatory process in patients with gout?

    • Yes, there is also an increasein PMN's

    • No, gout is not an inflammatory process

    Correct Answer
    A. Yes, there is also an increasein PMN's
    Explanation
    poly morpho nuclear cells are granulocytes.

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  • 21. 

    95% of the time does gout attack one joint or many joints?

    • One joint

    • Many joints

    Correct Answer
    A. One joint
  • 22. 

    Gicing a patient aspirin can lead to?

    • Overproduction of uric acid

    • Under excretion of uric acid

    Correct Answer
    A. Under excretion of uric acid
  • 23. 

    Gout is mostly a disease of:

    • Adolescent males

    • Adult males

    • Adolescent girls

    • Adult women

    Correct Answer
    A. Adult males
  • 24. 

    Which epideiological group NEVER suffers from gout?

    • Postmenopausal women

    • Premenopausal women

    • Adult men

    Correct Answer
    A. Premenopausal women
    Explanation
    Estrogen appears to be protective of developing gout.

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  • 25. 

    In the asymptomatic stage of gout, does the patient have hyperuricemia?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 26. 

    Can you have gouty arthritis and yet have NO hyperuricemia?

    • Yes

    • No

    Correct Answer
    A. Yes
    Explanation
    You never check for uric acid level to see if a patient has gout. The uric acid has moved out of the serum into the joint.

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  • 27. 

    Alloupurinol is used in the treatment of gout. Can allopurinol actually makes gout worse?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 28. 

    Other NSAIDS work just as well as indomethacin in alleviating the symptoms of gout. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 29. 

    If you treat chronic gout appropriately can the tophi go away?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 30. 

    Diagnosis of of gout is confirmed by:

    • Serum crystal level

    • Arthrocentesis

    • Clinical observation

    Correct Answer
    A. Arthrocentesis
  • 31. 

    ETOH leads to which process that leads to hyperuricemia?

    • Underexcretion only

    • Overproduction only

    • Both overproductoin and underexcretion

    Correct Answer
    A. Both overproductoin and underexcretion
  • 32. 

    The peak incidence of gout is in which decade of life?

    • 3d

    • 4th

    • 5th

    • 6th

    • 7th

    Correct Answer
    A. 5th
  • 33. 

    The following crystals can be found in synovial fluid. Which type is associated with acute and tophaceous gout and can be seen in asymptomatic hyperuricemia or intercritical gout?

    • Monosodium urate monohydrate crystals

    • Calcium pyrophsophate dihydrate crystals

    • Calcium oxalate

    Correct Answer
    A. Monosodium urate monohydrate crystals
  • 34. 

    Indomethacin is an NSAID that has been used extensively in the treatment of gout. Its use is limited now due to its propensity to be:

    • Hepatotoxic

    • Nephrotoxic

    • Ototoxic

    Correct Answer
    A. Nephrotoxic
  • 35. 

    Which of the following are used in the acute treatment of gout?

    • NSAIDS

    • Colchicine

    • Prednisone

    • Intrarticular steroid injection

    • Allopurinol

    Correct Answer(s)
    A. NSAIDS
    A. Colchicine
    A. Prednisone
    A. Intrarticular steroid injection
    Explanation
    allopurinol is used to treat chronic gout.

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  • 36. 

    What type of drug is probenecid?

    • A xanthine oxidase inhibitor

    • A uricosuric

    Correct Answer
    A. A uricosuric
  • 37. 

    What will the crystals look like if you do an arthrocentesis in a patient with psuedogout?

    • Needle like

    • Round

    • Rhomboid like

    Correct Answer
    A. Rhomboid like
  • 38. 

    Which stage of gout is characterized by intermittent attacks?

    • Assymptomatic

    • Acute

    • Chronic

    Correct Answer
    A. Acute
  • 39. 

    In males adult levels of urate are reached at what age?

    • At puberty

    • At late adolescents

    • In the early 20s

    Correct Answer
    A. At puberty
  • 40. 

    What joint in the body is NEVER affected by acute gouty arthritis?

    • Elbow

    • Shoulder

    • Knee

    • Ankle

    • 1st MtP

    Correct Answer
    A. Shoulder
  • 41. 

    Patients with gouty arthritis will often complain of AN ABRUPT ONSET of pain that began:

    • When they were at work

    • Late in the afternoon

    • Early in the morning

    • At night

    Correct Answer
    A. At night
  • 42. 

    Which of the following lead to hyperuricemia as a result of overproduction?

    • HGPRT or G6PD deficiency

    • PrPP synthetase overactivity

    • Myoproliferative disorders

    • Low dose aspririn

    • Sicle cell anemia

    Correct Answer(s)
    A. HGPRT or G6PD deficiency
    A. PrPP synthetase overactivity
    A. Myoproliferative disorders
    A. Sicle cell anemia
    Explanation
    low dose aspirin leads to undersecretion of uric acid.

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  • 43. 

    What is the upper limit for normal serum uric acid levels?

    • 6-6.5mg/dl

    • 7-7.5. mg/dl

    • 8-8.5mg/dl

    • 9-9.5mg/dl

    Correct Answer
    A. 8-8.5mg/dl
  • 44. 

    Basically uric acid is the end product of degradation of purine compunds. If you lack the following enzymes that are responsible for the oxidation of uric acid you can develop hyperuricemia?

    • Xanthine oxidase

    • Uric acid oxidase

    • Uricase

    Correct Answer(s)
    A. Uric acid oxidase
    A. Uricase
    Explanation
    xanthine oxidase is involved inthe formation of uric acid and not the break down.

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  • 45. 

    Which of the following are used to treat chronic gout?

    • Colchicine

    • Allopurinol

    • Probenecid

    • Uloric

    Correct Answer(s)
    A. Allopurinol
    A. Probenecid
    A. Uloric
  • 46. 

    What joint is usually initially affected by pseudogout?

    • The ankle

    • The 1st MTP

    • The knee

    • The hip

    Correct Answer
    A. The knee
  • 47. 

    What is the leukocyte count between in patients with Gout?

    • 50 000 - 80 000

    • 5000 -80 000

    • 15 000 - 20 000

    Correct Answer
    A. 5000 -80 000
  • 48. 

    The following are provocative facotrs of acute attacks of gout. Which factor is the reason why the first MTP is usually the first joint attacked by gout?

    • Trauma

    • Alcohol ingestion

    • Drugs such as thiazide diuretics, low dose aspirin and allopurinol

    Correct Answer
    A. Trauma
  • 49. 

    The following are all causes of early onset gout. Which one is the only one that is associated with premonopausal women developing gout?

    • Enzymatic defects inthe purine pathways

    • Glycogens torage disease

    • Hemoglobinaopathies

    • Familial urate nephropathy

    Correct Answer
    A. Familial urate nephropathy

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  • Feb 16, 2019
    Quiz Edited by
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  • May 08, 2010
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