1. Most of older patients have gout secondary to diuretic use and chronic kidney disease
2. Joints of the upper limbs are more frequently affected
3. Presentation is typical with acute attack of gout
Which of the statements given above are correct?
Gout in Old Age: Statement Analysis
This section analyzes the provided statements regarding gout in older adults to determine which are correct.
Statement 1: Secondary Gout Causes in Elderly
Statement 1 suggests that most older patients develop gout secondary to diuretic use and chronic kidney disease (CKD). This is generally considered correct. Elderly individuals are more prone to conditions like hypertension and heart failure, often treated with diuretics which can increase uric acid levels. Furthermore, the prevalence of CKD increases with age, and impaired kidney function reduces uric acid excretion, contributing significantly to secondary gout.
Statement 2: Upper Limb Joint Involvement
Statement 2 claims that joints of the upper limbs are more frequently affected in older patients. While classic gout often begins in the lower extremities (like the big toe), gout in the elderly can present differently. Polyarticular involvement, including upper limb joints (wrists, fingers), can be more common in older individuals, particularly with long-standing or poorly managed disease, compared to younger patients. Therefore, in the context of older adults, this statement is considered correct.
Statement 3: Typical Presentation
Statement 3 posits that the presentation is typically an acute attack of gout. While acute attacks are characteristic of gout, presentations in the elderly can often be atypical. Factors such as comorbidities, polypharmacy (including medications like NSAIDs or corticosteroids), and potentially altered pain perception can lead to less typical or milder symptoms, chronic arthritis, or tophi presentation rather than the classic severe, acute monoarthritis.
Conclusion on Correct Statements
Based on the analysis:
- Statement 1 is correct due to the higher prevalence of contributing factors like diuretic use and CKD in the elderly.
- Statement 2 is considered correct in the specific context of gout presentation in older adults, where upper limb involvement may be relatively more frequent than typically assumed.
- Statement 3 is incorrect because elderly patients frequently exhibit atypical presentations of gout, deviating from the classic acute attack.
Therefore, statements 1 and 2 are the correct ones.
Important Questions from Arthritis
- Which of the following statements regarding Ankylosing spondylitis (AS) are true?
1. AS occurs in about 10 % of Inflammatory Bowel Disease(IBD) patients
2. The AS activity is related to Bowel activity in IBD patients
3. The AS activity does remit with glucocorticoids or colectomy in IBD patients
Select the correct answer using the code given below: - Which of the following statements about “Early onset Osteoarthritis” are true?
1. Onset is usually before the age of 55 years
2. There is clear history of previous trauma
3. In most cases, single joint is affected
Select the correct answer using the code given below: - A 31-year young man presents with fever, weight loss, pain with swelling of knee joint and low backache with stiffness. Three weeks earlier, he was treated for symptoms of urinary tract infection by local practitioner. The joint aspirate is leucocyte rich and contains multinucleated macrophages. His urine culture is sterile. What is the most probable diagnosis?
- A 28-year old woman complains of arthritis involving bilateral metacarpophalangeal, proximal interphalangeal and wrist joints of one year duration. The most likely disease entity is:
- Which of the following are the complications of Rheumatoid arthritis?
1. Peripheral entrapment neuropathies
2. Subluxation of the cervical spine at the atlanto-axial joint
3. Primary amyloidosis
4. Lymphoma
Select the correct answer using the code given below:
