Question 1
Which of the following anti-gout medications works by inhibiting the URAT-1 transporter and GLUT9 transporter?
(A) Probenecid
(B) Feboxustat
(C) Allopurinol
(D) Rasburicase
(E) Anakinra
A: URAT-1 is an organic anion exchanger found on the apical surfaces of the proximal tubule, whilst GLUT-9 is a transporter found on the basolateral surface. Proc Natl Acad Sci U S A. 2009 Sep 8;106(36)
Question 2
What is an appropriate pharmacological strategy when using xanthine oxidase inhibitors in the prophylaxis treatment of gout without tophi?
(A) Maintain serum uric acid <0.3 mM
(B) Maintain serum uric acid <0.36 mM
(C) Increase the allopurinol dose to a maximum after slow up-titration irrespective of the serum urate level
(D) Reduce the number of acute gout exacerbations to <3 per year
(E) Up-titration based on renal function rather than tolerability to achieve serum uric acid targets
B: If there are no tophi, the medical journal of australia recommends serum uric acid levels be maintained <0.36mM. Up-titration to a maximum level needed to suppress uric acid levels <0.36 should be based on tolerability rather than renal function. Serum uric acid levels should be maintained less than <0.3 mM if there is the presence of tophi. Med J Aust 2015; 203 (2): 86-88.
Question 3
Which of the following joints is closely associated with obesity and osteoarthritis?
(A) Subtalar
(B) Hand
(C) Knee
(D) Hip
(E) Elbow
C: Knee has the greatest association, then hand then hip! Uptodate 2016
Which of the following anti-gout medications works by inhibiting the URAT-1 transporter and GLUT9 transporter?
(A) Probenecid
(B) Feboxustat
(C) Allopurinol
(D) Rasburicase
(E) Anakinra
A: URAT-1 is an organic anion exchanger found on the apical surfaces of the proximal tubule, whilst GLUT-9 is a transporter found on the basolateral surface. Proc Natl Acad Sci U S A. 2009 Sep 8;106(36)
Question 2
What is an appropriate pharmacological strategy when using xanthine oxidase inhibitors in the prophylaxis treatment of gout without tophi?
(A) Maintain serum uric acid <0.3 mM
(B) Maintain serum uric acid <0.36 mM
(C) Increase the allopurinol dose to a maximum after slow up-titration irrespective of the serum urate level
(D) Reduce the number of acute gout exacerbations to <3 per year
(E) Up-titration based on renal function rather than tolerability to achieve serum uric acid targets
B: If there are no tophi, the medical journal of australia recommends serum uric acid levels be maintained <0.36mM. Up-titration to a maximum level needed to suppress uric acid levels <0.36 should be based on tolerability rather than renal function. Serum uric acid levels should be maintained less than <0.3 mM if there is the presence of tophi. Med J Aust 2015; 203 (2): 86-88.
Question 3
Which of the following joints is closely associated with obesity and osteoarthritis?
(A) Subtalar
(B) Hand
(C) Knee
(D) Hip
(E) Elbow
C: Knee has the greatest association, then hand then hip! Uptodate 2016