DrVirgo
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About 90% of the patients will be underexcreters... Treat with Probenacid.
Only about 10% will be overproducers (these are the patients who have tumor lysis syndrome for example)... Treat with Allopurinol.
But for acute gouty attack treatment is: NSAIDS, Colchicine, Steroids.
(Steroids in elderly patients who can't tolerate NSAIDS or Colchicine)
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| paviraj
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24-hr urine uric acid determination-<800mg/day -UNDERSECRETION- URICOSURIC AGENT
>800mg/d - OVERPRODUCERS - ALLOPURINAL.
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| mjl1717
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yes, 800 is the #.
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| usmle_dmc
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Thank you all so much.
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| DrVirgo
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I have a couple more questions on gout:
1. On an x-ray of a joint that has abeen involved in multiple gouty attacks you would expect to find _____________.
2. On synovial fluid analysis the MSU crystals are negatively birefringent and needle shaped. The number of WBC's should be between ________________.
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| DrVirgo
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| neuroblastoma
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2. On synovial fluid analysis the MSU crystals are negatively birefringent and needle shaped. The number of WBC's should be between ________________.
5000 TO 50,000
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| neuroblastoma
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SEPTIC ARTHRITIS-- WBC MORE THAN 50.000
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| DrVirgo
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Right. Just read that too! 
What about
1. What do we find in x-ray with multiple gouty attacks??
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| neuroblastoma
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Rat bite appearance
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| mjl1717
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And the most accurate test to diagnose gout??
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| DrVirgo
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Most accurate for Gout:
Negatively birefringent needle shaped monosodium urate crystals in the joint fluid?
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| mjl1717
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synovial tissue bx
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| DrPak
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Most accurate way to diagnose= joint aspirate.
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