IPLab:Lab 5:Gout - Revision history

Peter Anderson: /* Study Questions */

2016-12-05T12:29:23Z

‎Study Questions

Peter Anderson: /* Study Questions */

2016-12-05T12:23:11Z

‎Study Questions

Peter Anderson: /* Journal Articles */

2016-11-04T13:30:21Z

‎Journal Articles

Seung Park at 16:15, 3 January 2014

2014-01-03T16:15:36Z

Seung Park: /* Images */

2013-08-30T01:33:30Z

‎Images

Seung Park at 20:52, 22 August 2013

2013-08-22T20:52:44Z

Seung Park at 15:15, 21 August 2013

2013-08-21T15:15:59Z

Seung Park at 14:20, 21 August 2013

2013-08-21T14:20:08Z

Seung Park at 14:19, 21 August 2013

2013-08-21T14:19:40Z

Peter Anderson: Created page with "== Images == File:IPLab5Gout1.jpg|This is a gross photograph of an index finger from a patient with gout. The finger has been sectione..."

2013-08-20T15:21:07Z

Created page with "== Images == <gallery heights="250px" widths="250px"> File:IPLab5Gout1.jpg|This is a gross photograph of an index finger from a patient with gout. The finger has been sectione..."

New page

== Images ==
<gallery heights="250px" widths="250px">
File:IPLab5Gout1.jpg|This is a gross photograph of an index finger from a patient with gout. The finger has been sectioned longitudinally to demonstrate the distal interphalangeal joint. Note the white chalky material within and adjacent to the joint (arrows).
File:IPLab5Gout2.jpg|This is a gross photograph of the elbow of this patient. The subcutaneous nodules (arrows) on this arm are tophi caused by gout.
File:IPLab5Gout3.jpg|This is a low-power photomicrograph of the tophus removed from the elbow of this patient. Note the fibrous connective tissue (1) and the large foci containing the urate crystals (2) surrounded by the intense chronic inflammatory reaction.
File:IPLab5Gout4.jpg|This higher-power photomicrograph of the tophus demonstrates the collections of urate crystals (1) and the inflammatory cells at the edge of these foci (2).
File:IPLab5Gout5.jpg|This is a higher-power photomicrograph of the edge of the tophus. Most of the urate crystals dissolve away during processing. The inflammatory cells at the edge of these foci are clearly visible (arrow).
File:IPLab5Gout6.jpg|This is a high-power photomicrograph of the edge of the tophus. The character of the intense chronic inflammatory cell reaction is evident and note the presence of giant cells within this inflammatory cell reaction (arrows).
File:IPLab5Gout7.jpg|This is a photomicrograph of a tophus that was fixed in alcohol prior to histologic processing. The alcohol fixation preserves the water soluble urate crystals within the tissue. Note the urate crystals visible in this photomicrograph (arrows). Also note the chronic inflammatory reaction in the background.
File:IPLab5Gout8.jpg|This is a gross photograph of a tophus on the great toe of another patient with gout (arrow). The healed surgical incision and the size of this tophus indicate that this was a long-standing problem for this patient.
</gallery>

{{IPLab 5}}

[[Category: IPLab:Lab 5]]

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 == Study Questions ==
-* <spoiler text="What are the two types of gout and which is more common?">The main type is primary gout which makes up 90% of all cases. In most cases of primary gout the specific enzyme defect is unknown but there is some enzyme abnormality which leads to hyperuricemia and symptoms of gout. In about 10% of cases cases the enzyme defect is known, but gout symptomatology is the main clinical finding.
+* <spoiler text="What are the two types of gout and which is more common?">The main type is primary gout which makes up 90% of all cases. In most cases of primary gout the specific enzyme defect is unknown but there is some enzyme abnormality which leads to hyperuricemia and symptoms of gout. In rare cases the specific enzyme defect is known, but gout symptomatology is the main clinical finding.
 In secondary gout the cause of the hyperuricemia is known (e.g. leukemia, renal failure, Lesch-Nyhan syndrome).</spoiler>

@@ Line 21: / Line 21: @@
 == Study Questions ==
-* <spoiler text="What are the two types of gout and which is more common?">The main type is primary gout which makes up 90% of all cases. In most cases of primary gout the enzyme defect is unknown. In rare cases the enzyme defect is known, but gout symptomatology is the main clinical finding.
+* <spoiler text="What are the two types of gout and which is more common?">The main type is primary gout which makes up 90% of all cases. In most cases of primary gout the specific enzyme defect is unknown but there is some enzyme abnormality which leads to hyperuricemia and symptoms of gout. In about 10% of cases cases the enzyme defect is known, but gout symptomatology is the main clinical finding.
 In secondary gout the cause of the hyperuricemia is known (e.g. leukemia, renal failure, Lesch-Nyhan syndrome).</spoiler>

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 * Harris MD, Siegel LB, Alloway JA.  [http://www.ncbi.nlm.nih.gov/pubmed/10068714 Gout and hyperuricemia].  ''Am Fam Physician'' 1999 Feb 15;59(4):925-34.
 * Pittman JR, Bross MH.  [http://www.ncbi.nlm.nih.gov/pubmed/10208700 Diagnosis and management of gout].  ''Am Fam Physician'' 1999 Apr 1;59(7):1799-806, 1810.
 === Images ===

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 === Images ===
-* [http://peir.path.uab.edu/library/index.php?/tags/784-gout PEIR Digital Library: Gout Images]
+* [{{SERVER}}/library/index.php?/tags/784-gout PEIR Digital Library: Gout Images]
 == Related IPLab Cases ==

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 * <spoiler text="Why is gout more severe in peripheral joints?">The decreased temperature accentuates the crystallization of monosodium urate (MSU).</spoiler>
 * <spoiler text="What initiates the inflammatory reaction seen in the synovial membrane in gouty arthritis?">MSU crystals are chemotactic and they activate complement. This initiates a cascade of inflammatory events which leads to acute gouty arthritis.</spoiler>
 {{IPLab 5}}
 [[Category: IPLab:Lab 5]]

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 File:IPLab5Gout8.jpg|This is a gross photograph of a tophus on the great toe of another patient with gout (arrow). The healed surgical incision and the size of this tophus indicate that this was a long-standing problem for this patient.
 </gallery>
 == Study Questions ==

← Older revision		Revision as of 14:20, 21 August 2013
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−	== Clinical Summary ===	+	== Clinical Summary ==
	This patient was diagnosed with gout approximately 20 years ago. At that time, he noted the gradual onset of pain in the left knee, followed by swelling, redness and heat, all of which persisted for approximately one month. Shortly thereafter, he had periodic episodes of hot, painful, swollen joints involving the left knee, left ankle, and both first metatarsophalangeal joints. At this time the patient was hospitalized for evaluation of these arthritides. Serum uric acid values on three separate occasions were 8.0, 9.3, and 8.7 mg/dl. In addition to the presence of the painful swollen joints, a gouty tophus was present on the left arm. The patient was readmitted to the hospital from time to time because of acute exacerbations of gouty arthritis. On the most recent hospital admission, a 3-cm tophus was found over the right elbow, as well as several smaller tophi over the right hand.		This patient was diagnosed with gout approximately 20 years ago. At that time, he noted the gradual onset of pain in the left knee, followed by swelling, redness and heat, all of which persisted for approximately one month. Shortly thereafter, he had periodic episodes of hot, painful, swollen joints involving the left knee, left ankle, and both first metatarsophalangeal joints. At this time the patient was hospitalized for evaluation of these arthritides. Serum uric acid values on three separate occasions were 8.0, 9.3, and 8.7 mg/dl. In addition to the presence of the painful swollen joints, a gouty tophus was present on the left arm. The patient was readmitted to the hospital from time to time because of acute exacerbations of gouty arthritis. On the most recent hospital admission, a 3-cm tophus was found over the right elbow, as well as several smaller tophi over the right hand.

← Older revision		Revision as of 14:19, 21 August 2013
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		+	== Clinical Summary ===
		+	This patient was diagnosed with gout approximately 20 years ago. At that time, he noted the gradual onset of pain in the left knee, followed by swelling, redness and heat, all of which persisted for approximately one month. Shortly thereafter, he had periodic episodes of hot, painful, swollen joints involving the left knee, left ankle, and both first metatarsophalangeal joints. At this time the patient was hospitalized for evaluation of these arthritides. Serum uric acid values on three separate occasions were 8.0, 9.3, and 8.7 mg/dl. In addition to the presence of the painful swollen joints, a gouty tophus was present on the left arm. The patient was readmitted to the hospital from time to time because of acute exacerbations of gouty arthritis. On the most recent hospital admission, a 3-cm tophus was found over the right elbow, as well as several smaller tophi over the right hand.
		+
		+	== Autopsy Findings ==
		+	The specimen consisted of an elliptically shaped, mottled, yellow-white irregular hard mass, measuring 8.0 x 5.0 x 2.0 cm. in diameter.
		+
	== Images ==		== Images ==
	<gallery heights="250px" widths="250px">		<gallery heights="250px" widths="250px">