Crystal Associated Arthropathies (Msq Drill 153)
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- 1.
Initial attack of gout in 75% of patients is in the:
- A.
1st MCP
- B.
2nd MTP
- C.
3rd MCP
- D.
1st MTP
Correct Answer
D. 1st MTP -
- 2.
Diagnosis of of gout is confirmed by:
- A.
Serum crystal level
- B.
Arthrocentesis
- C.
Clinical observation
Correct Answer
B. Arthrocentesis -
- 3.
Under polarized microscopy gout crystals will look:
- A.
Needle shaped
- B.
Round shaped
- C.
Rhomboid shaped
Correct Answer
A. Needle shaped -
- 4.
Does the joint fluid show an inflammatory process in patients with gout?
- A.
Yes, there is also an increasein PMN's
- B.
No, gout is not an inflammatory process
Correct Answer
A. Yes, there is also an increasein PMN'sExplanation
poly morpho nuclear cells are granulocytes.Rate this question:
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- 5.
95% of the time does gout attack one joint or many joints?
- A.
One joint
- B.
Many joints
Correct Answer
A. One joint -
- 6.
Gout is basically hyperuricemia. How can hyperuricemia come about?
- A.
Increased production only
- B.
Decreased excretion only
- C.
Both increased production and decreased secretion
Correct Answer
C. Both increased production and decreased secretion -
- 7.
Processes that lead to increased breakdown of cellular components results in increased production ofuric acid. Which of the following can lead to hyperuricemia die to increased production?
- A.
Leukemia
- B.
Diuretics
- C.
Hemolytic anemia
- D.
Idiopathic
Correct Answer(s)
A. Leukemia
C. Hemolytic anemia
D. IdiopathicExplanation
diuretics lead to hyperuricemia due to undersecretion as they compete with uric acid crystals at the distal tubules.Rate this question:
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- 8.
ETOH leads to which process that leads to hyperuricemia?
- A.
Underexcretion only
- B.
Overproduction only
- C.
Both overproductoin and underexcretion
Correct Answer
C. Both overproductoin and underexcretion -
- 9.
Uric acid levels confirm a diagnosis of gout. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
A patient may have asymptomatic hyperuricemia that does not need to be treated.Rate this question:
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- 10.
Which of the following lead to hyperuricemia as a result of overproduction?
- A.
HGPRT or G6PD deficiency
- B.
PrPP synthetase overactivity
- C.
Myoproliferative disorders
- D.
Low dose aspririn
- E.
Sicle cell anemia
Correct Answer(s)
A. HGPRT or G6PD deficiency
B. PrPP synthetase overactivity
C. Myoproliferative disorders
E. Sicle cell anemiaExplanation
low dose aspirin leads to undersecretion of uric acid.Rate this question:
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- 11.
Gicing a patient aspirin can lead to?
- A.
Overproduction of uric acid
- B.
Under excretion of uric acid
Correct Answer
B. Under excretion of uric acid -
- 12.
Which of the following are other drugs and toxins that can lead to UNDEREXCRETION of uric acid therefore hyperuricemia?
- A.
Diuretics esp HCTZ
- B.
Ethanol
- C.
Cyclosporine A
- D.
Pyrazinaide
- E.
Lead neprhopathy
Correct Answer(s)
A. Diuretics esp HCTZ
B. Ethanol
C. Cyclosporine A
D. Pyrazinaide
E. Lead neprhopathy -
- 13.
Gout is mostly a disease of:
- A.
Adolescent males
- B.
Adult males
- C.
Adolescent girls
- D.
Adult women
Correct Answer
B. Adult males -
- 14.
The peak incidence of gout is in which decade of life?
- A.
3d
- B.
4th
- C.
5th
- D.
6th
- E.
7th
Correct Answer
C. 5th -
- 15.
Which epideiological group NEVER suffers from gout?
- A.
Postmenopausal women
- B.
Premenopausal women
- C.
Adult men
Correct Answer
B. Premenopausal womenExplanation
Estrogen appears to be protective of developing gout.Rate this question:
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- 16.
After monopause, does the incidence of gout in women increase?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 17.
Which stage of gout is characterized by intermittent attacks?
- A.
Assymptomatic
- B.
Acute
- C.
Chronic
Correct Answer
B. Acute -
- 18.
Which stage of gout is characterized by tophaceous nodules?
- A.
Asympatomatic
- B.
Acute
- C.
Chronic
Correct Answer
C. Chronic -
- 19.
In the asymptomatic stage of gout, does the patient have hyperuricemia?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 20.
What is the upper limit for normal serum uric acid levels?
- A.
6-6.5mg/dl
- B.
7-7.5. mg/dl
- C.
8-8.5mg/dl
- D.
9-9.5mg/dl
Correct Answer
C. 8-8.5mg/dl -
- 21.
In males adult levels of urate are reached at what age?
- A.
At puberty
- B.
At late adolescents
- C.
In the early 20s
Correct Answer
A. At puberty -
- 22.
In females the same adult levels are reached at:
- A.
Puberty
- B.
Later adolescents
- C.
Menopause
Correct Answer
C. Menopause -
- 23.
The vast majority of patients with hyperuricemia do hot have symptoms. True or false?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
You do not have to treat asymptomatic pts with hyperuricemia.Rate this question:
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- 24.
What joint in the body is NEVER affected by acute gouty arthritis?
- A.
Elbow
- B.
Shoulder
- C.
Knee
- D.
Ankle
- E.
1st MtP
Correct Answer
B. Shoulder -
- 25.
Patients with gouty arthritis will often complain of AN ABRUPT ONSET of pain that began:
- A.
When they were at work
- B.
Late in the afternoon
- C.
Early in the morning
- D.
At night
Correct Answer
D. At night -
- 26.
Is gout usually monoarticular or polyarticular?
- A.
Monoarticular
- B.
Polyarticular
Correct Answer
A. Monoarticular -
- 27.
Does the gouty arthritis usually subside on it own?
- A.
Yes in about 3-10 days
- B.
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 -
- 28.
So, urate crystals will be present in synovial fluid?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 29.
Can you have gouty arthritis and yet have NO hyperuricemia?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
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.Rate this question:
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- 30.
If you have multiple intermittent attacks of acute gout, you can eventually develop tophi anywhere over the body. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 31.
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?
- A.
Xanthine oxidase
- B.
Uric acid oxidase
- C.
Uricase
Correct Answer(s)
B. Uric acid oxidase
C. UricaseExplanation
xanthine oxidase is involved inthe formation of uric acid and not the break down.Rate this question:
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- 32.
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?
- A.
Trauma
- B.
Alcohol ingestion
- C.
Drugs such as thiazide diuretics, low dose aspirin and allopurinol
Correct Answer
A. Trauma -
- 33.
Alloupurinol is used in the treatment of gout. Can allopurinol actually makes gout worse?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 34.
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?
- A.
True
- B.
False
Correct Answer
A. True -
- 35.
Is there a strong familial link to gout?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 36.
The following are all causes of early onset gout. Which one is the only one that is associated with premonopausal women developing gout?
- A.
Enzymatic defects inthe purine pathways
- B.
Glycogens torage disease
- C.
Hemoglobinaopathies
- D.
Familial urate nephropathy
Correct Answer
D. Familial urate nepHropathy -
- 37.
DanPatients who have a had a transplant and are taking _____ have a very high risk of developing gout.
- A.
Methotrexate
- B.
Sulfasalizine
- C.
Cyclosporine
- D.
Azathiprine
Correct Answer
C. Cyclosporine -
- 38.
These patients who have had a transplant and are taking cyclosporine will still have an episode of asymptomatic hyperuricemia, the only difference is that this episode will be shorter than average or will last longer than average?
- A.
Lasts longer
- B.
Lasts for a shorter time
Correct Answer
B. Lasts for a shorter time -
- 39.
In other words patients who have had a transplant and are taking cyclosporine will have rapid development of tophi. true or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 40.
What is the leukocyte count between in patients with Gout?
- A.
50 000 - 80 000
- B.
5000 -80 000
- C.
15 000 - 20 000
Correct Answer
B. 5000 -80 000 -
- 41.
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?
- A.
Monosodium urate monohydrate crystals
- B.
Calcium pyrophsophate dihydrate crystals
- C.
Calcium oxalate
Correct Answer
A. Monosodium urate monohydrate crystals -
- 42.
So psuedogout is:
- A.
Monosodium urate monohydrate
- B.
Calcium pyrophosphate dihydrate
- C.
Calcium oxalate
- D.
Calcium phosphate
Correct Answer
B. Calcium pyropHospHate dihydrateExplanation
other causes for calcium pyrophosphate dihydrate crystals are asymptomatic chondroclacinosis and chronic arthropathy.Rate this question:
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- 43.
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:
- A.
Hepatotoxic
- B.
Nephrotoxic
- C.
Ototoxic
Correct Answer
B. NepHrotoxic -
- 44.
Other NSAIDS work just as well as indomethacin in alleviating the symptoms of gout. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 45.
Which of the following are used in the acute treatment of gout?
- A.
NSAIDS
- B.
Colchicine
- C.
Prednisone
- D.
Intrarticular steroid injection
- E.
Allopurinol
Correct Answer(s)
A. NSAIDS
B. Colchicine
C. Prednisone
D. Intrarticular steroid injectionExplanation
allopurinol is used to treat chronic gout.Rate this question:
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- 46.
Which of the following are used to treat chronic gout?
- A.
Colchicine
- B.
Allopurinol
- C.
Probenecid
- D.
Uloric
Correct Answer(s)
B. Allopurinol
C. Probenecid
D. Uloric -
- 47.
So, basically you should use allopurino, probenecid and uloric to treat chornic gout after stabilization by acute meds. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 48.
What type of drug is probenecid?
- A.
A xanthine oxidase inhibitor
- B.
A uricosuric
Correct Answer
B. A uricosuric -
- 49.
If you treat chronic gout appropriately can the tophi go away?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 50.
Psuedogout is caused by calcium pyrophosphate dihydrate crystals. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
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Feb 16, 2019Quiz Edited by
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May 08, 2010Quiz Created by
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