Pathophysiology of Gout

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- Discussion:
    - humans lack the enzyme uricase which is involved in elimination of excess
            nucleic acid purines & nitrogenous waste products thru production and
            excretion of allantoic acid;
            - hence in humans, uric acid is end product of purines degradation;
    - gouty arthritis begins w/ deposition of MSU crystals in synovial &
            periarticular tissue;
    - factors related to microtophus formation:
            - reduced solubility of MSU at the periphery of the body because of
                  lower temperatures;
            - weight bearing (MTP joint incurs high force / area);