beats/minute

[cali7925]

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anyone remember the average beats per minute for men and women....its been a long time and my shatty memory has made me forget.

oh wait, another question....in acute gouty arthritis, why does a rapid lowering of serum uric acid increase AGA attacks....i would think it would decrease the attacks...unless the uric acid gets sucked into the joints?....and what is the relationship betw. urate and uric acid?

thanks guys....and if u got ?'s...keep em coming, that way we can all get done with this horrific exam.

 

[lattimer13]

urate = uric acid

like lactate = lactic acid or glutamate = glutamic acid

Men ~ 70 bpm
Women ~ 75 bpm
(googled it)

 

[RS6]

Cali, this is a great question. There does seem to be some evidence that an acute fall in the levels of serum uric acid (urate) can parodixcally percipitate an acute gouty arthritis (AGA). This is particularly seen in patients with gout that have never been managed with colchicine.

To answer your question....no one really knows why this occurs, at least it has not been elucidated in any medical or scientific journals. However, there is one popular potential explanation. When the serum uric acid levels are acutely lowered, neutrophils are more efficient in phagocytosing urate crystals and in initiating gouty inflammation than when in the hyperuricemic state. The reasons, why this is true are not known. In addition, the increased uric acid excretion in the kidneys can promote stone formation. Therefore, make sure your patients are well hydrated. Also, avoid agents like probenicid that increase uric acid concentration in the kidney ureters, if you suspect urolithiasis.

For step 1 purposes, you do not need to know about paradoxical AGA being a complication of acute lowering of serum urate crystals, especially the mechanism by which this occurs. I would concentrate on the various drugs, like allopurinol, colchicine, probenicid, indomethacin, and even losartan, which has been shown to be the only ARB that has a natural uricosuric effect. Know how each of these work, why they work, and contraindications. (i.e. no indomethicin if gastric bleeding, no probenicid if history of urolithiasis)

Good luck and keep asking these great questions.....

 

[bigfrank]

Beats/minute? I don't know, but I think it's more in men. 😉

 

[Pox in a box]

Beats/minute? I don't know, but I think it's more in men. 😉

What page was that on in Harrison's?

 

[bigfrank]

What page was that on in Harrison's?

Back to trolling? Where is that Step I score??????????

 

[Pox in a box]

Back to trolling? Where is that Step I score??????????

Seriously, what page is that on in Harrison's?

 

[ANGII]

when you first administer uric acid lowering agents such as Allopurinol
( Zyloric) these agents "first" compete with uric acid for excretion at the tubules of the kidney causing an increase in uric acid levels in blood and causing the attacks ..... and after about 1-3 weeks of treatment these attacks become less occuring as the levels of uric acid are diminished ....
Thanx to my Pharmacology Professor for this unique piece of information !