Four stages of gout

(1) Asx hyperuricemia

(2) Acute gouty arthritis

(3) Intercritical gout

(4) Chronic tophaceous gout

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• antithyroid therapy

propylthiouracil & methimazole

- therapy used to prep pt for RAI therapy or sgx; not a mono therapy

- may take 2-8 wks to see response

- safe to use in pregnancy

- need baseline LFTs & CBC; recheck frequently during therapy

• Medicationsthat may cause hypothyroidism

amiodarone

dopamine

lithium

interferon

thalidomide

stavudine

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