All About Gout for Primary Care

March 20, 2017

How to regulate “the king of diseases and the disease of kings” is this Patient Care Special Report's domain.

Gout, “the king of diseases and the disease of kings,” remains the most common inflammatory arthropathy.1 A disorder of purine metabolism, gout has more than doubled in prevalence over the past 2 decades.2 The majority of patients who have gout will receive most to all of their gout care from their primary care provider.3

[[{"type":"media","view_mode":"media_crop","fid":"57618","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_7971727308062","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"7258","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"width: 235px; height: 235px; border-width: 0px; border-style: solid; margin: 5px; float: right;","title":" ","typeof":"foaf:Image"}}]]In upcoming articles in this Special Report, we will review the current guidelines for the diagnosis and management of gout-everything primary care physicians need to know.

Topics will include:

The basic components of gout diagnosis

Management of acute gout attacks

Pharmacological interventions for acute gout

Management of chronic gout

Pharmacological interventions for chronic gout

Prevention of future gout attacks

Referral to rheumatology

 

First up: a gout multiple-choice pre-test aimed at primary care physicians. The questions will be answered in upcoming segments of this Special Report and you will see them again, as a post-test, at the conclusion of the series.

 

Continue to Gout Special Report Pre-test

 

PRE-TEST

Take our short pre-test to see what you know about gout and the current guidelines for disease diagnosis and treatment for acute and chronic disease.

 

Question 1:

Answer and Question #2 on Next Page »

The correct answer is C. Crystal examination

 

Question 2.

Answer and Question #3 on Next Page »

The correct answer is A. Chronic hyperuricemia

 

Question 3.

Answer and Question #4 on Next Page »

The correct answer is E. A and C but not B (Maximum inflammation within 12 to 24 hours is a hallmark.)

 

Question 4.

Answer and Question #5 on Next Page »

The correct answer is C. 30%

 

Question 5.

Answer and Question #6 on Next Page »

The correct answer is B. Useful for chronic gout but not for acute gout

 

Question 6.

Answer and Question #7 on Next Page »

The correct answer is D. Allopurinol

 

Question 7.

Answer and Question #8 on Next Page »

The correct answer is C. 1.2 mg within 12 hours of onset, 0.6 mg 1 hour later

 

Question 8.

Answer and Question #9 on Next Page »

The correct answer is D. A starting dose of 40 to 60 mg/d with a taper over 10 to 14 days

 

Question 9.

Answer and Question #10 on Next Page »

The correct answer is C. < 6 mg/dL

 

Question 10.

Answer on Next Page »

The correct answer is B. Allopurinol

 

The next installment in this Special Report about gout in primary care: Diagnosis.

References:

1. Choi H. Epidemiology of crystal arthropathy. Rheum Dis Clin North Am. 2006;32:255-273, v.

2. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States., part II. Arthritis Rheum. 2008;58:26-35.

3. Jawad AS. Teaching rheumatology in primary care. Ann Rheum Dis. 2000;59:1000-1001.