Exit this survey >> Gout in the Golden Years -- Pre-Test 1. Pre-Test Questionnaire Question Title Please take a minute to complete this pre-session survey to help ARHP assess the impact of its educational programs. Completing this survey will provide ARHP with an invaluable tool for understanding how health professionals use educational offerings and how ARHP activities might be improved to serve you better. Question Title * 1. Your primary professional category (choose the one best response): Health Professional Educator Nurse Midwife Nurse Practitioner Pharmacist Physician Physician Assistant Registered Nurse Resident Student Other (please specify) Question Title * 2. Do you interact with patients? Yes No Question Title * 3. Which of the following factors has contributed to the rise in incidence and prevalence of gout among adult men and women in the United States? A. Increased consumption of foods high in fructose corn syrup B. Increased consumption of alcohol, especially beer C. Comorbid health conditions such as hypertension and obesity D. All of the above Question Title * 4. Which of the following is more likely to be present in women who develop gout? A. Obesity B. Alcoholism C. Treatment with diuretics D. Age at onset in mid-40s Question Title * 5. What is the estimated percent decrease in serum uric acid levels attributed to nonpharmacologic interventions? A. 8% B. 18% C. 22% D. 25% Question Title * 6. Which of the following is an indication that a patient requires urate-lowering therapy? A. ≥ 2 gout attacks per year B. High consumption of beer C. Serum uric acid level of 6 mg/dL D. Inability to tolerate first-line therapy with colchicine Question Title * 7. Sonia Graham is a 60-year-old woman presenting to you with her third acute gout attack in the past 18 months. The affected joint is the right great toe and Sonia characterizes the pain as a 10 of 10, even when she is not putting weight on her foot. Her previous attacks also affected the right great toe and upon examination, you note that the joint is swollen, erythematous, and exquisitely sensitive to touch. What is your first priority in Sonia’s treatment plan? A. Obtain an MRI to determine the degree of disease progression B. Initiate naproxen and colchicine for treatment for the acute gout attack C. Initiate urate-lowering treatment with a xanthine oxidase inhibitor such as allopurinol or febuxostat D. Both b and c Question Title * 8. Following successful management of Sonia’s acute gout attack, you review her medical and social history with her and perform a complete physical exam. Sonia is in good health with a BMI of 23.4. She reports intermittent use of alcohol, usually wine, indicating that she may have about 1 glass every 2 to 3 weeks. She also indicates that she participates in in a water aerobics exercise program 4 to 5 times per week. Laboratory evaluations reveal that her serum uric acid levels are 8.6 mg/dL. In order to lower her uric acid levels to prevent future gout attacks, you prescribe single-agent allopurinol and schedule a re-evaluation of her serum uric acid levels in 4 weeks. At follow-up, Sonia’s serum uric acid level remains elevated at 8.2 mg/dL. What would you next prescribe for Sonia to lower her serum uric acid levels and decrease her risk of gout and progressive joint damage? A. Switch from allopurinol to febuxostat B. Prescribe pegloticase C. Prescribe probenecid in combination with allopurinol D. Continue the allopurinol and recommend that Sonia increase her consumption of fruits, vegetables, and low-fat dairy products Question Title * 9. In order to assess the amount of synovial and soft tissue inflammation as well as the composition of tophi, which of the following exams do you order for Sonia? A. Synovial fluid aspiration B. CT scan C. Ultrasound D. B or C E. All of the above Question Title * 10. At her next follow-up appointment, Sonia reports that she has had no gout attacks and asks if she can discontinue her urate-lowering regimen. You explain that maintenance of urate-lowering treatment is essential for prevention of recurrent attacks and further disease progression. As you review her medications with Sonia, which includes probenecid 500 mg BID, you remind Sonia that the following class of medications is contraindicated for individuals taking probenecid. A. Salicylates B. Non-selective nonsteroidal antiinflammatory inhibitors C. COX 2 inhibitors D. Antihistamines Question Title * 11. As a result of participating in this activity, I hope to be better able to: Next >>