Learn / FMK
Every FMK condition
299 diseases, deficiencies, toxicities and drug mechanisms harvested from every FMK deck — the ones sprinkled through a single bullet as much as the ones with their own slide. Pick what you're given and what you have to name, or let it cycle; distractors come from the same category so you have to discriminate (hypoketotic vs. ketotic hypoglycemia, which GSD, which urea-cycle enzyme…). Every answer shows the whole card with the lecture and slide.
Nucleotide · FMK 08.1
Hyperuricemia — underexcretion (primary and secondary) Acquired / not inherited
Defect / target: Renal urate excretory defect: primary/idiopathic, or secondary to lactic acidosis, thiazide diuretics, other drug/environmental factors
Mechanism: Reduced renal excretion of uric acid (>90% of hyperuricemia cases); lactic acidosis competitively increases renal urate reabsorption and thiazides impair urate excretion, raising serum urate toward the crystallization threshold.
↑ Accumulates: Uric acid (serum)
Presentation: Usually asymptomatic until gout or urate nephrolithiasis develops
Labs: Elevated serum uric acid
Treatment: Uricosuric agents (probenecid, sulfinpyrazone) to increase renal uric acid excretion; goal serum urate below saturation point (~6.5 mg/dL)
Underexcretion = >90% of cases; overproduction = <10%
Learn the mechanism: Purine degradation & uric acid →
FMK 08.1 Nucleic Acid Metabolism · slide 19, 20