Gout is a disease that usually presents with recurrent attacks of acute inflammatory arthritis. Gout attacks are sudden with severe pain, burning, and swelling. Gout typically occurs in ___ joint, which is most often the __________ joint.

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Gout is a disease that usually presents with recurrent attacks of acute inflammatory arthritis. Gout attacks are sudden with severe pain, burning, and swelling. Gout typically occurs in one joint, which is most often the methatarsophalangeal joint (the big toe).

False. When uric acid builds up in the blood, the patient may remain asymptomatic (many people with high uric acid, or hyperuricemia, never get gout) or the uric acid can crystallize in the joints, resulting in a painful gout attack. Gout typically strikes after many years of persistent hyperuricemia.

Male Sex

Overweight (2 - 3 x increased risk)

Excessive alcohol consumption (beer)

Hypertension

Renal insufficiency

Advanced age

Using meds that increase uric acid

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Studies confirm that total protein intake (purine rick foods) is not associated with increased uric acid levels.

NO! If you are given a case with elevated uric acid, do not choose treatment unless a gout attack has occured. Asymptomatic hyperuricemia is not treated.

diuretics (thiazides, loops)

niacin

aspirin

cyclosporing

levodopa

pyrazinamide

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Note: drugs used to treat an acute attack (colchicine, NSAIDS, steroids) are different than the drugs used to prevent attacks. Colchicine, however, is sometimes used during the initiation of prophylacitc therapy to reduce the risk of acute attacks which can occur when uric acid is lowered rapidly.