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Title: gout
Description: medical science(simplest)

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GOUT
ARTICULAR CRYSTAL DEPOSITION IS ASSOCIATED WITH
 MONOSODIUM URATE-GOUT
 CALCIUM PYROPHOSPHATE
 BASIC CALCIUM PHOSPHATE

“DISEASE OF KINGS”

EPIDEMIOLOGY OF GOUT
 USUALLY ADULT MEN
 5% FEMALE-RARE IN CHILDREN AND AN WOMAN

DURING REPRODUCTVE YRS

 POSITIVE CORELATION-PROTEIN INTAKE ,MEAN

WT,ALCOHOL CONSUMPTION,SOCIAL
CLASS,INTELLIGNCE

GOUT

CLASSIFICATION OF GOUT
Primary gout(90%)
Diet
unknown Enzyme defect
Known enzyme defect(HGPRT)
Reduced excretion of uric acid

Gout classi……
SECONDARY GOUT(10%)
A) OVER PRODUCTION LESS EXCRETION
(LEUKEMIA AND AGGRESSIVE
NEOPLASM)
B) INBORN ERROR OF METABOLISM(HGPRT)
C) REDUCED EXCRETION-CHR RENAL FAILURE


PATHOGENESIS
OF GOUT

Purine metabolism
I ) de novo pathway
II) Salvage pathway

 HYPERURICEMIA
 Renal transport system
 GFR
 Reabsorption
 Secretion
 Post secretory reabsorption

Hypoxanthine guanine
phospho ribosyl transferase
(HGPRT)

CONTRIBUTING FACTOR FOR GOUT
 Age > 20-30
 Genetic predoposition-X linked multifactorial runs

in family

 Heavy alcohol
 Obesity
 Drugs-thiazine
 Lead toxicity

PATHOGENESIS……
...
ACUTE ARTHRITIS
 2
...
TOPHI AT MULTI SITES
 4
...
ASYMTOMATIC HYPERRICEMIA
2
...
INTERCRITICAL GOUT
4
...


TUBERCULAR ARTHRITIS
 HAEMATOGENOUS SPREAD
 SECONDARY TO PULMONARY TUBERCULOSIS


Title: gout
Description: medical science(simplest)