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CRYSTAL-ASSOCIATED DISEASE

الكلية كلية طب حمورابي     القسم الكلية ذات القسم الواحد     المرحلة 5
أستاذ المادة صباح جاسم محمد الربيعي       05/06/2017 08:26:40
CRYSTAL-ASSOCIATED DISEASE
•COMMON: MSUM, CPPD,BCP.
•UNCOMMON: CHOLESTROL, CA OXALATE, EXTRINSIC, SEMI CRYSTILLE, SYNTHETIC CRY., PLANT THORN/SEA, URCHIN SPINES.
Gout: The pathological reaction of joint or periarticular tissue to presence of mono sodium urate monohydrate crystal(MSUM) . M/F: > 5/1. It is one of most common inflammatory arthritis of men and of older women. The prevalance increases with increase of serum uric acid and with age and with increase of metabolic syndrome in which hyperuricemia is an integral component. Hyperuricaemea is a serum uric acid level greater than 2 SD above the mean for a population. 0.40 mmol/l or 6.7 mg/dl for men. 0.35 mmol/l or 5.9 mg/dl for women. only a minority of patient with hyperuricemia develop gout.
Aetiology: Primary gout: 1/3 of serum uric acid source from diet. And 2/3 from endogenous metabolism of purines. The level depend on the balance between synthesis and elimination by the kidneys and gut(2/3 renal, 1/3 gut) hyperuricaemia can result either from:. Diminished renal excretion: -inherited renal tubular defect -renal failure Chronic drug therapy(thiaizides and loop diuretics, low dose aspirin, ciclosporin ,pyrazinamide -lead toxicity -lactic acidosis(alcohol) OR Increase production: -increase purine turnover(chroonicmyeloproliferative or lymphoproleferative disorders(e.g polycythemia ,chronic lymphatic lukemia) -increase de novo synthesis unidentified abnormality. specific enzymatic defect(Hypoxanthine-guinine phosphoribosyl transferase(HGPRT) deficiency Phosphoribosyl pyrophosphate synthetase over-activity(PRPP). Glucose-6-phosphatase deficiency. .
RECENT STUDIES HAVE IDENTIFIED POLYMORPHISMS IN SEVERAL GENES THAT ENCODE URATE TRANSPORTERS.
VERY RARELY (<1%) HAVE INHERITED DEFECT IN PURINE METABOLISM, WHICH SUSPECTED IN: 1-UNDER AGE OF 25 YEARS. 2-RENAL CALCULI 3-STRONG FAMILY HISTORY OF EARLY-ONSET GOUT

المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .