NSG 555 quiz 3 LATEST 2026
QUESTINS AND VERIFIED
gout - correct answer usually recurrent episodes of painful arthritis in 1 joint in men or 4 or less
joints in postmenopausal womena nd in men with subsequent flares. if not treated causes
structural damage
4 stages of gout - correct answer asymptomatic hyperuricemia
acute gout attacks
intercritical gout (intervals between acute attacks)
and chronic tophaceous gout
podagra - correct answer synovitis at first MTP joint of big toe
Heberden nodes and Bouchard nodes - correct answer hard, non-tender, non-inflammatory
nodules (bony growths) of the interphalangeal joints
dx of gout - correct answer needle aspiration. MSU crystals in synovial fluid or tophus aspiration
is gold standard for confirmation
other options include inflam markers (duh, these will be elevated)
Cr
SU
xray shows punched out erosions and favorable response to colchicine or NSAIDs
differential dx of gout - correct answer pseudogout (calcium pyrophosphate crystals)--US can
distinguish between gout and pseudogout
,lyme disease
septic arthritis
inflamm. arthritis
RA (needle aspiration distinguishes)
nonpharm mgt gout - correct answer avoid etoh, low fat dair products are better, reduce dairy
overall, DASH diet
acute gout treatment - correct answer goal is to terminate pain and inflammation
NSAID--first
colchicine--within 36 hours of attack 1.2 mg then 0.6 1 horu later
corticosteroids--first (esp if eGFR <60)
adrenocorticotropic hormone
chronic gout treatment - correct answer goal is to reduce SU level
start if 2+ attacks in 1 year
Do not start during attack
allopurinol preferred
if allergy use febuxostat
prophylaxis treatment for gout - correct answer start allopurinol or febuxostate (if renal disease
or allergy to allopurinol0 with low dose colchicine
Septic arthritis - correct answer this is a edical emergency
can be caused post0viral infection, bacterial or fungi.
, chikungunya viral arthritis (mosquito)
most common bacterial cause of septic arthritis - correct answer staph aureus
common cause of septic arthritis from STI - correct answer N gonorrhoeae
presentation and PE of septic arthritis - correct answer acute painful red swollen joint that is
warm to touch
pain @ rest and with motion/weight bearing.
fluid accumulation
may have fever or rigors
knee and hip are most commonly affected
Gonococcal arthritis - correct answer Joint pain w/ papules, pustules, or vesicles on reddened
bases, located on distal extremities
tx: 1 gram ceftriaxone IM or IV q25 hours + 1 gram azithromycinX1 dose
this will result in rapid response and can be diagnostic
prosthetic joint infections in septic arthritis - correct answer usually from s. aureus
best dx is to aspirate fluid from joint or tissue
lyme disease septic arthritis - correct answer timing from tick bit:
early (day 1-30)
early disseminated (days to 10 months)
late (months to years)
QUESTINS AND VERIFIED
gout - correct answer usually recurrent episodes of painful arthritis in 1 joint in men or 4 or less
joints in postmenopausal womena nd in men with subsequent flares. if not treated causes
structural damage
4 stages of gout - correct answer asymptomatic hyperuricemia
acute gout attacks
intercritical gout (intervals between acute attacks)
and chronic tophaceous gout
podagra - correct answer synovitis at first MTP joint of big toe
Heberden nodes and Bouchard nodes - correct answer hard, non-tender, non-inflammatory
nodules (bony growths) of the interphalangeal joints
dx of gout - correct answer needle aspiration. MSU crystals in synovial fluid or tophus aspiration
is gold standard for confirmation
other options include inflam markers (duh, these will be elevated)
Cr
SU
xray shows punched out erosions and favorable response to colchicine or NSAIDs
differential dx of gout - correct answer pseudogout (calcium pyrophosphate crystals)--US can
distinguish between gout and pseudogout
,lyme disease
septic arthritis
inflamm. arthritis
RA (needle aspiration distinguishes)
nonpharm mgt gout - correct answer avoid etoh, low fat dair products are better, reduce dairy
overall, DASH diet
acute gout treatment - correct answer goal is to terminate pain and inflammation
NSAID--first
colchicine--within 36 hours of attack 1.2 mg then 0.6 1 horu later
corticosteroids--first (esp if eGFR <60)
adrenocorticotropic hormone
chronic gout treatment - correct answer goal is to reduce SU level
start if 2+ attacks in 1 year
Do not start during attack
allopurinol preferred
if allergy use febuxostat
prophylaxis treatment for gout - correct answer start allopurinol or febuxostate (if renal disease
or allergy to allopurinol0 with low dose colchicine
Septic arthritis - correct answer this is a edical emergency
can be caused post0viral infection, bacterial or fungi.
, chikungunya viral arthritis (mosquito)
most common bacterial cause of septic arthritis - correct answer staph aureus
common cause of septic arthritis from STI - correct answer N gonorrhoeae
presentation and PE of septic arthritis - correct answer acute painful red swollen joint that is
warm to touch
pain @ rest and with motion/weight bearing.
fluid accumulation
may have fever or rigors
knee and hip are most commonly affected
Gonococcal arthritis - correct answer Joint pain w/ papules, pustules, or vesicles on reddened
bases, located on distal extremities
tx: 1 gram ceftriaxone IM or IV q25 hours + 1 gram azithromycinX1 dose
this will result in rapid response and can be diagnostic
prosthetic joint infections in septic arthritis - correct answer usually from s. aureus
best dx is to aspirate fluid from joint or tissue
lyme disease septic arthritis - correct answer timing from tick bit:
early (day 1-30)
early disseminated (days to 10 months)
late (months to years)
