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Kaplan Qbank USMLE



Author8 Posts
  #1

A 73 year old male presented with an acute attack of gout in his left knee.
What is the most likely underlying metabolic cause?
Available marks are shown in brackets
1 ) decreased renal excretion of uric acid
2 ) endogenous overproduction of uric acid
3 ) excessive dietary purine intake
4 ) lactic acidosis
5 ) starvation

  #2

1 ) decreased renal excretion of uric acid

  #3

yep 1

  #4

absolutely

  #5

WHAT HAPEEN IN PATIENT WITH INCREASED CELL TURN OVER. THEY HAVE NORMAL RENAL FXN BUT THAY GET ACUTE GOUT AND HOW ABOUT PERSON WHO IS HGRPT DEFICIENT. I WAS DEBATING ABOUT CHOICE B.WOULD'T U SEE INCREASED IN SERUM U.ACID LEVEL RISE BEFORE IT GOES TO JOINTS.

  #6

hello Peekay,
In gout, the cause due to decreased excretion of uric acid is much more common than increased production. I forget the exact data, sorry about that.

  #7

In the majority of patients (almost 90%) with primary gout, hyperuricemia results from relative renal urate underexcretion ("relative urate underexcretors"), while in about 10% of subjects, hyperuricemia is due to endogenous overproduction of uric acid ("urate overproducers")

  #8

THANK YOU VERY MUCH EVERY ONE. YOUR HELP IS APPRECIATED







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