text:
CC Sept 2017 Goutrename
echoecho's version from 2017-10-01 17:14
|What is gout?
|an inflammatory arthropathy resulting from preciptation of MSU (monosodium urate) crystals in the joint space (can also accumulate in bones, cartilage, tendons and bursae)
|What is chronic gout?
|gouty attacks are recurrent, resulting in chronic gout (associated with accumulation s of urate deposits called tophi)
|How many Americans are affected by gout?
|8 million
|List the risk factors of gout?
|older age, male, black race, diminished renal function, obesity
|What diets are high in purines?
|red meats, organ meats, purine-riche seafoods (sardines, shellfish), high-fructose corn syrup, alcoholic beverages (especially beer)
|List the medications associated with increased risk of gout?
|thiazide, loop diuretics, lower doses of ASA (81-325 mg), high dose niacin, Levodopa, Cyclosporine, Losartan, Atorvastatin, Bactrim, igher doses of ASA 91-2 g/day)
|How does acute gout present?
|as a mooarticular arthritis of sudden onset, associated with redness, swelling and pain
|Which joint is commonly affected?
|metatarsophalangeal (MTP) joint
|List conditions that mimic gout?
|infectious arthritis, calcium pyrophosphate deposition disease, rheumatoid arthritis, OA, psoriatic arthritis
|Is an elevated uric acid level necessary for the dx of acute gout?
|List the diagnostic criteria for acute gout developed by the American College of Rheumatology?
|1) presence of monosodium urate (MSU) crystals in joint fluid AND/OR 2) presence of tophus known to have MSU crystals AND/OR 3) presence of 6 of the following = 1)more than 1 attack of acute arthritis 2) development of maximal inflammation within 1 day 3) attack of monoarticular arthritis 4) observation of joint erythema 5) pain or swelling of the first MTP 6) unilateral attack involving the first MTP 7) unilateral attack involving the tarsal joint 8) suspected tophus 9) hyperuricemia 10) asymmetric swelling within a joint on x-ray 11) subcortical cyst without erosion on x-ray 12) negative culture of joint fluid for microorganisms during an acute attack
|*** Both the ACR (2015) and the American College of Physicians (ACP) give strong recommendations for the use of what medications for gout?
|NSAIDS, oral colchicine, systemic corticosteroids
|Are all options equally effective?
|What therapy is an option for severe cases with polyarticular or large joint involvement?
|combination therapy
|Comment on NSAIDs use in gout?
|1) should be given at maximum dosing 2) continued until acute attack has resolved 3) NSAIDS have analgesic and anti-inflammatory properties 4) side effects of NSAIDS are renal injury, GI bleed and cardiovascular complications
|Comment on Colchicine use in gout?
|1) low-dose (1.2 mg followed by 0.6 mg 1 hour later OR 0.6 mg every 8 hours) is as effective as higher doses recommended in the past (1.2 mg followed by 0.6 mg hourly x 6 hours) 2) has a lower risk of GI bleeding
|What type of patients should not use colchicine?
|renal or hepatic insufficiency patients
|Comment on corticosteroid use in gout?
|1) it is an option for those who can't tolerate NSAIDs or colchicine. 2) 40-60 mg /day x 5-10 days OR 2-5 days followed by tapering over 7-10 days 3) intra-articular steroids are an option if large joints are involved
|What can be applied to the affected joint to relieve pain but does not affect swelling?
|What education should be given the patient with gout?
|1) change medications that cause gout 2) dietary modifications 3) alcohol moderation 4) weight management
|*** What is the new thinking about urate-lowering therapy (long term)?
|since there is uncertain benefit over the long term and potential adverse effects, the ACP recommends that urate lowering therapy NOT be initiated for most patients with first gout attack or for those with infrequent attacks
|*** List the 4 indications by the American College of Rheumatology indications for urate lowering therapy?
|Established dx of gouty arthritis AND 1) tophus or tophi by clinical exam of radiography 2) frequent attacks of acute gouty arthritis (> 2 per year) 3) chronic kidney disease stage 2 or worse 4) past urolithiasis
|What are the first line recommendations of urate-lowering therapy (xanthine oxidative inhibitors)?
|1) allopurinol (Zyloprim) 2) febuxostat (Uloric)
|What are the side effects of Allopurinol?
|rash (potential fatal hypersensitivity reaction is more likely in Asian patients)
|What are the side effects of Febuxostat?
|1) GI 2) musculoskeletal pain
|Comment on Probenecid?
|1) a uricosuric agent 2) an option for patients who underexcrete uric acid and have normal renal function 3) delay ULT until 2 weeks after resolution of the acute attack
|Since initiation of ULT is associated with a flare of acute gouty symptoms, what can be used?
|colchicine prophylaxis (0.6 mg once or twice a day) OR low-dose NSAIDS (Naproxen 250 mg BID) is recommended along with the ULT
|When is colchicine discontinued?
|when the patient is asymptomatic for 6 months and tophi have resolved
|What medications are a second-line option for gout if other meds are contraindicated or not tolerated?
|oral corticosteroids
|If the patient has no symptoms of gout while on ULT and prophylaxis, duration of prophylactic therapy is ____ months after achieving target uric acid level in an individual without tophi or ____ months after attaining goal uric acid (if > 1 tophi are noted on exam)?
|3; 6
|Should patients with ongoing symptoms of gout remain on prophylaxis?
|*** The goal of urate lowering therapy (ULT) is uric acid level < _____ to ____ mg/dL. Levels , _____ mg/dL may be necessary to improve gout signs and symptoms?
|5 to 6; 5
|Intensification of therapy by doing what may be necessary if the uric acid goal is not achieved?
|maximizing dose, addition of probenecid to a xanthine oxidative inhibitors such as Allopurinol or Febuxostat
|Should ULT be continued indefinitely along with other lifestyle measures and interventions?
|*** SUMMARY = Define gout?
|an inflammatory arthropathy caused by precipitation of monosodium urate crystals in joints and other tissues
|*** SUMMARY = List risk factors?
|1) dietary excess 2) alcohol consumption 3) some medications
|*** SUMMARY = List recommended interventions for an acute gout attack?
|1) colchicine 2) maximum dose NSAIDs 3) corticosteroids
|*** SUMMARY = Urate-lowering therapy (ULT) is NOT recommended for what?
|1) first gouty attack or 2) infrequent attacks
|*** SUMMARY = What is the goal of ULT for uric acid levels?
|< 5-6 mg/dL
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The Englishwoman Vol 3 of 5 A Novel
Williss Current Notes
Dogmatic Theology A Synopsis of Christian Theology
Letters from Across the Sea 1907-1908
Liber Amoris Being the Book of Love of Brother Aurelius
Compendium Florae Belgicae Vol 2 Conjunctis Studiis
Letters of Harvey Fisk With an Introductory Memoir
Fortieth Annual Report of the Womans Foreign Missionary Society of the Methodist Episcopal Church 1909
The Pioneers or the Sources of the Susquehanna Vol 2 of 2 A Descriptive Tale
Browning Poet and Man A Survey
The Widow Married Vol 2 of 3 A Sequel to The Widow Barnaby
Down the Way Vol 1 of 3 A Novel
In Cupids Chains or a Slave for Life
Letters of Princess Elizabeth of England Daughter of King George III and Landgravine of Hesse-Homburg Written for the Most Part to Miss Louisa Swinburne Daughter of Henry Swinburne Esq Author of Courts of Europe Etc
Theatre of Education Vol 4 of 4
History of England Vol 1 From the Earliest Times to the Death of Henry VII
The Triumph A Collection of Music Containing an Introductory Course for Congregational Singing Theory of Music and Teachers Manual Elementary Intermediate and Advanced Courses for Singing Schools and Musical Conventions
The Cronicle History of Henry the Fift with His Battell Fought at Agin Court in France Togither with Auntient Pistoll As It Hath Bene Sundry Times Playd by the Right Honourable the Lord Chamberlaine His Servants
A Collection of Hymns from Various Authors Intended as a Supplement to Dr Watts Psalms and Hymns
The Worlds Greatest Books Vol 14 Philosophy (Continued) Economics
Memoirs of General Lafayette and of the French Revolution of 1830 Vol 1 of 2
The Ivory Fan
Proceedings of the Annual Congress of the National Prison Association of the United States Lincoln Nebraska October 21-25 1905
The Truth about Vignolles
The Humorous Speaker Being a Choice Collection of Amusing Pieces Both in Prose and Verse Original and Selected Consisting of Dialogues Soliloquies Parodies C
Welded Links
The Books of Joshua Judges Ruth I and II Samuel I and II Kings The Common Version Revised with an Introduction and Occasional Notes
Londons Lure An Anthology in Prose and Verse
The Poles in the Seventeenth Century Vol 1 of 3 An Historical Novel with a Sketch of the Polish Cossacks
Histoire Abrge de la Musique Et Des Musiciens
Consolidator Vol 2 January 1937
Lives of the Lords Strangford With Their Ancestors and Contemporaries Through Ten Generations
The Poetical Works of Henry Kirke White
The Pope Vol 1 of 3 A Novel
A Collection of the Most Esteemed Farces and Entertainments Performed on the British Stage Vol 4
Mexico Ancient and Modern Vol 2 of 2
James Calvert of Fiji
Allowances of Certain Claims Reported by Court of Claims Under Bowman and Tucker Acts Report
For Ever An Essay on Eternal Punishment
The Dramatic Works and Lyrics of Ben Jonson Selected with an Essay Biographical and Critical
A Modern Adam and Eve in a Garden
The Life of the Right Honourable Francis North Baron of Guilford Lord Keeper of the Great Seal Under King Charles II and King James II A Sketch of Roman Manners and Customs
Pin Money Vol 3 of 3 A Novel
Expository Thoughts on the Gospels Vol 2 For Family and Private Use With the Text Complete St John
The Viking Guy Legend of the Moxahala And Other Poems
The Life of Christ and Other Poems
Memoirs of Mrs Coghlan Vol 1 of 2
The Works of the British Poets Vol 10 With Lives of the Authors Butler C
The Origin of Tyranny
Society in a Garrison Town Vol 1 of 3 A Novel
Outlaw and Lawmaker Vol 1 of 3
The Great Events Vol 5 By Famous Historians
Memoires Presentes a Monseigneur Le Duc DOrleans Regent de France Vol 1 Contenant Les Moyens de Rendre Ce Royaume Tres-Puissant Et DAugmenter Confiderablement Les Revenus Du Roi Et Du Peuple
Cherry and Violet A Tale of the Great Plague
Select Comedies Translated from the Italian of Goldoni Giraud and Nota
The Arts and Artists or Anecdotes and Relics of the Schools of Painting Scuplture and Architecture Vol 3
Expressman and the Detective
The Religious History of New England Kings Chapel Lectures
The Postmaster of Market Deignton
A Commentary on the Poetry of Chaucer Spenser
Countess Helena A Novel
The Perfection of Man by Charity A Spiritual Treatise
The Reproach of Annesley Vol 3 of 3
The Playtime Naturalist
Simply a Love-Story
The Best of All Complete
Appendix and Documents Annexed to the Memoir Filed by the Minister of Paraguay on the Question Submitted to Arbitration
The Jewish Spy Vol 4 Being a Philosophical Historical and Critical Correspondence by Letters Which Lately Passed Between Certain Jews in Turkey Italy France C
6 000 Tons of Gold
The Poems of Sydney Dobell Selected with an Introductory Memoir
Madame Elizabeth de France 1764-1794
With Mask and Mitt
In Letters of Gold Vol 1 of 2
Salvator Vol 3 Suite Et Fin Des Mohicans de Paris
Corinna or Italy Vol 2 of 3
Tales from Ariosto
Constance DOyley Vol 1 of 3 A Tale
The Irrigation Age Vol 7 July December 1894
Sylvias World And Crimes Which the Law Does Not Reach
Ballads and Lyrical Pieces
A Philosophical History of the Formation of the American Republic From Its Beginning to the End of the Civil War
Concordance to the Poetical Works of Alexander Pope
Ambition Vol 3 of 3
Decision Vol 1 of 3 A Tale
Iris Vol 1 of 3
A Discussion of the Original Institution Perpetuity and Change of the Weekly Sabbath In a Series of Letters from January 1835 to July 1836 Written for the American Baptist City of New York Which Excepting the Last Series Were Published Accordi
Warrens Reading Selections With an Introduction Illustrating the Principles of Rhetorical Reading
By the Way of a Scripture Interpretation Theism a Prophecy or Prophetical Dissertation Predicting and Declaring the Coming of the Expected Messiah in the Character of Lord and King Vol 1 The Setting Up of a National Theocracy in the Calling of Th
On the Wing of Occasions Being the Authorized Version of Certain Curious Episodes of the Late Civil War Including the Hitherto Suppressed Narrative of the Kidnapping of President Lincoln
Percy Hamilton Vol 1 of 3 Or the Adventures of a Westminster Boy
The Tower of London Vol 2
From a Middlesex Garden A Book of Garden Thoughts
The Lyric Works of Horace Translated Into English Verse to Which Are Added a Number of Original Poems
Manual of Bacteriological Technique and Special Bacteriology
The Court of Cacus or the Story of Burke and Hare
The Novels and Miscellaneous Works of Daniel de Foe Vol 15 With a Biographical Memoir of the Author Literary Prefaces to the Various Pieces Illustrative Notes Etc
A Troublesome Name
Under the Big Dipper
The Green Eyes of Bast
Historical Memoirs of His Own Time Vol 4 of 4
Rustum Khan or Fourteen Nights Entertainment at the Shah Bhag or Royal Gardens at Ahmedabad Vol 2 of 3
Many Waters A Story of New York
The False Step And the Sisters Vol 3 of 3
Plays of Edmond Rostand Vol 2
Hymns and Songs for the Sunday School
Hemans Poems
History and Civil Government of Maine And the Government of the United States
The Age and the Church Being a Study of the Age and of the Adaptation of the Church to Its Needs
The Pennsylvania Farm Journal Vol 5 Devoted to Agriculture Horticulture and Rural Economy
In the Days of My Youth Vol 2 of 3
The Roxburghe Ballads Vol 6 Edited with Special Introductions and Notes Part 3
A Great Treason Vol 2 A Story of the War of Independence
Life in the West Back-Wood Leaves and Prairie Flowers Rough Sketches on the Borders of the Picturesque the Sublime and Ridiculous Extracts from the Note Book of Morleigh in Search of an Estate
The Marriage of Edward
Nana Sequel to Lassommoir
Discourses on Religious Subjects
Domestic Duties or Instructions to Young Married Ladies on the Management of Their Households and the Regulation of Their Conduct in the Various Relations and Duties of Married Life
He Masters Word in the Epistles and Gospels Vol 2 Sermons for All the Sundays and the Principal Feasts of the Year
A Collection of Poems Vol 5 of 6 By Several Hands
Honor Carmichael Vol 2 of 2 A Study
Bull-Dog Drummond The Adventures of a Demobilised Officer Who Found Peace Dull
The Awakening of Scotland A History from 1747 to 1797
Tony Pastors Complete Budget of Comic Songs Containing a Collection of Several Hundred Original Local Lays Eccentric Lyrics Comic Songs Humorous Irish Ballads Patriotic Vocal Gems Stump Speeches and Burlesque Orations As Written Sung and Delive
The Iliad of Homer Vol 3
The Saints Hymnal A Compilation of Hymns for the Use of Church and Church School Congregations of the Reorganized Church of Jesus Christ of Latter Day Saints
The Presbyterian Church A Brief Account of Its Doctrine Worship and Polity
The Heart Chord A Story That Just Grew Unfolding Widely-Varied Phases of American Life as Viewed in Editorial Work on a Country Weekly Daily Newspaper and Magazine
Histoire Naturelle Des Crustaces Contenant Leur Description Et Leurs Moeurs Vol 2 Avec Figures Dessinees DApres Nature
The Naval Officer or Scenes and Adventures in the Life of Frank Mildmay Vol 2 of 3
Prayers and Ceremonies of the Mass or Moral Doctrinal and Liturgical Explanations of the Prayers and Ceremonies of the Mass
Hillingdon Hall or the Cockney Squire Vol 3 of 3 A Tale of Country Life
The Pacha of Many Tales Vol 1 of 3
The Tale of the Ten Vol 2 of 3 A Salt-Water Romance
Ella Vol 1 of 3 Or the Emperors Son
Fulfilment of Scripture Prophecy As Exhibited in Ancient History and Modern Travels
Electric Light Installations and the Management of Accumulators
Norway Nights and Russian Days
The Stanley Tales Vol 4 of 6 Original and Select
Pictures from Greek Life and Story
DOrsay or the Complete Dandy
The Early Religion of Israel Vol 2 As Set Forth by Biblical Writers and by Modern Critical Historians
To Panama and Back the Record of an Experience
The Russian Bastile Or the Schluesselburg Fortress
The Greek and the Turk Or Powers and Prospects in the Levant
Graded Physical Exercises
Stories of Ancient Rome
Institutes of Surgery Arranged in the Order of the Lectures Delivered in the University of Edinburgh Vol 2 of 2
The Complete Sportsman (Compiled from the Occasional Papers of Reginald Drake Biffin)
The Letters of Saint Teresa Vol 2 A Complete Edition Translated from the Spanish and Annotated by the Benedictines of Stanbrook
Imagination Labour Civilization
Peers and Parvenus Vol 2 of 3 A Novel
The Pastors Fire-Side a Novel Vol 2 of 4 In Four
The Housekeepers Guide A Vade Mecum Containing a Very Choice Collection of Recipes and Practical Information for Every Home with Blank Pages for New Recipes
History of the American Theatre
The Roua Pass Vol 2 of 3 Or Englishmen in the Highlands
An Abridged History of the United States For the Use of Schools
A History of England Vol 4 of 8 From the First Invasion by the Romans
Willkirliche Hervorbringung Des Geschlechts Bei Mensch Und Hausthieren Die
Romantic Narratives From Scottish History and Tradition
Les Aventures de Saturnin Fichet Ou La Conspiration de la Rouarie Deuxiime Sirie
Theory of the Earth Vol 3 of 4 With Proofs and Illustrations
Introduction to Theory of Analytic Function
Kit Carson The Pioneer of the West
The German Soldier in the Wars of the United States
Principles and Practice of Filling Teeth
Geschichte Der Neuhochdeutschen Grammatik Von Den Anfingen Bis Auf Adelung Vol 1
Verhandlungen Des Historischen Vereines Fir Niederbayern Vol 43
Indian Appropriation Bill Hearings Before a Subcommittee of the Comittee on Indian Affairs of the House of Representatives Consisting of Hon John H Stephens Chairman Hon Charles D Carter Hon Charles H Burke 1914
Europes Handicap Tribe and Class
Bulletin de la Montagne Ste Geneviive Et Ses Abords 1899-1902 Vol 3 Comiti DiTudes Historiques Archiologiques Et Artistiques (Ve Et Xiiie Arrondissements)
Memorial of the Celebration of the Centenary of Savings Banks Held at Edinburgh 8th 9th and 10th June 1910
With British Guns in Italy a Tribute to Italian Achievement
A Latina A First Latin Book Including Accidence Rules of Syntax Exercises Vocabularies and Rules for Construing
An Old English Home and Its Dependencies
An Introduction to the Book of the Old and New Testament Vol 14
Wayside and Woodland Blossoms A Pocket Guide to British Wild-Flowers for the Country Rambler
The Maine Bugle January 1894
A Memoir of William Pengelly of Torquay F R S Geologist with a Selection from His Correspondence With a Summary of His Scientific Work
English Humorists of To-Day
Memoirs Vol 2 of 2
The Prophecies of Jesus Christ Relating to His Death Resurrection and Second Coming and Their Fulfilment
Biblical Review Intended as a New and Improved Commentary on the Bible Vol 1 Wherein the Author Attempts to Give More Rational Interpretations of Subjects and Passages Than Are Common in Works Having the Same General Purpose On a Plan That Renders T
The History of the Life of Reginald Pole Vol 2
The Search After Proserpine and Other Poems Classical and Meditative
The Heart of Holland
Selections from the Prose and Poetry of John Henry Newman
Alexander Henderson Churchman and Statesman
A Spanish Grammar
From Serbia to Jugoslavia Serbias Victories Reverses and Final Triumph
Legends of the Lintel and the Ley
Genealogical Sketches of Robert and John Hazelton and Some of Their Descendants With Brief Notices of Other New England Families Bearing This Name
The Old Testament from the Modern Point of View
An Essay on the Existence of a Supreme Creator Possessed of Infinite Power Wisdom and Goodness Vol 1
Literary Remains Old Testament Characters Delineated and Illustrated
A Lonely Summer in Kashmir
Essay on Divorce Divorce Legislation with Special Reference to the United States
Motives and Expression in Religious Education A Manual of Worship Hand-Work Play and Service
Studies Essays In English Literature
Christian Greece and Living Greek
History of Westtown Boarding School 1799-1899
The Reserve Officers Handbook
Paris With Pen and Pencil Its People and Literature Its Life and Business
The History of England
Lectures on Justice Police Revenue and Arms
Archbishop Darboy and Some French Tragedies 1813-1871
Vivonio Vol 4 of 4 A Romance
The Romance of the Peerage Vol 2 Or Curiosities of Family History
World Patriots
Dutensiana Vol 5 of 5 Intended as a Sequel to the Memories of a Traveller Now in Retirement
The Life of Gen Francis Marion Also Lives of Generals Moultier and Pickens and Governor Rutledge With Sketches of Other Distinguished Heroes and Patriots Who Served in the Revolutionary War in the Southern States
The Letters of Simkin the Second Poetic Recorder of All the Proceedings Upon the Trial of Warren Hastings Esq in Westminster Hall
English Biography
The Rise Fall and Revival of Dental Prosthesis
The Rise and Fall of the High Commission
Hygiene of Women and Children
Jack Vol 2
Views and Reviews Essays in Appreciation
Unaddressed Letters
Lectures on English Poetry From the Reign of Edward the Third to the Time of Burns and Cowper
A Practical Treatise on Modern Gas and Oil Engines
Hierurgia or the Holy Sacrifice of the Mass Vol 1 of 2 With Notes and Dissertations Elucidating Its Doctrines and Ceremonies and Numerous Illustrative Plates
The Works of George Meredith Vol 4 Eva Harrington a Novel Volume II
About Music and What It Is Made A Book for Amateurs
The Tribunal of the Terror A Study of Paris in 1793-1795
The Apocryphal Books of the Old Testament Proved to Be Corrupt Additions to the Word of God The Arguments of Romanists from the Infallibility of the Church and the Testimony of the Fathers in Behalf of the Apocrypha Discussed and Refuted
The Deciding Voice of the Monuments in Biblical Criticism
A Treatise on Industrial Photometry with Special Application to Electric
The Last Secrets The Final Mysteries of Exploration
Journal of the Society for Psychical Research Vol 10
Six Months in Persia Vol 1 of 2
Traite Du Nivellement Comprenant La Theorie Et La Pratique Du Nivellement Ordinaire Et Des Nivellements Expeditifs Dits Preparatoires Ou de Reconnaissance
Le Morte Darthur Vol 1 of 4 The Book of King Arthur and of His Noble Knights of the Round Table
Reciprocity with Canada Hearings Before the Committee on Ways and Means of the House of Representatives 61st Congress 3D Session on H R 32216 February 2 4 6 7 8 and 9 1911
Marriage Licenses Granted Within the Archdeaconry of Chester in the Diocese of Chester 1667-1680 Vol 6
Principles of Political Economy
Tobacco and Human Efficiency
Philosophical Transactions of the Royal Society of London Vol 75 For the Year 1785 Part I
Advocate of Peace Vol 93 1931 Also Volume 94 March 1932
Circular Instruction of the Treasury Department Related to the Tariff Navigation and Other Laws For the Year Ending December 31 1877
Menology of the Society of Jesus English-Speaking Assistancy Vol 1 Comprising the Provinces of England Ireland Maryland and Missouri Together with the Missions of Canada and New Orleans
Patron and Place-Hunter A Study of George Bubb Dodington Lord Melcombe
The Life of Baron Frederic Trenck Vol 3 Containing His Adventures
Eleventh Annual Report of the Agricultural Experiment Station Of the University of Minnesota Fiscal Year July 1 1902 to June 30 1903
Thirty-Ninth Annual Report of Department of Geology and Natural Resources Indiana
Memoirs of George Elers Captain in the 12th Regiment of Foot (1777-1842) To Which Are Added Correspondence and Other Papers with Genealogy and Notes
Review of the Department of the Navys Investigation Into the Gun Turret Explosion Aboard the Iowa
The Empire Review and Magazine 1910 Vol 19
The Strength of Nations An Argument from History
Henry Nicholson Ellacombe A Memoir
Pathology of the Nervous System
The Old-Time Parson
Psychology and Theology Or Psychology Applied to the Investigation of Questions Relating to Religion Natural Theology and Revelation
The Art and Practice of Typography A Manual of American Printing
University of California Publications in Classical Philology Vol 14 1950 1952
The Bee-Keepers Review Vol 6 A Monthly Journal Devoted to the Interests of Honey Producers Jan 10 1893
An Outline History of the United States For Public and Other Schools From the Earliest Period to the Present Time
The Chicago Synod and Its Antecedents
The Scottish Historical Review Vol 15 October 1917-July 1918
The Last Three Soldiers
The Complete Works of William Shakespeare Vol 3 Loves Labours Lost A Midsommer Nights Dreame The Merchant of Venice
Woods Medical and Surgical Monographs Vol 5 Consisting of Original Treatises and Reproductions in English of Books and Monographs Selected from the Latest Literature of Foreign Countries with All Illustrations Etc March 1890
A Discourse Concerning the Designd Establishment of a New Colony to the South of Carolina in the Most Delightful Country of the Universe
History of the Town of Whately Mass Including a Narrative of Leading Events from the First Planting of Hatfield 1660-1871
Monumental Java
Anthology of Magazine Verse for 1919 And Year Book of American Poetry
Topography of Great Britain or British Travellers Pocket Directory Vol 2
A Collection of Voyages and Travels Vol 27 of 28 From the Period of the Discovery of America to the Commencement of the Nineteenth Century
The Condition of Women and Children Among the Celtic Gothic and Other Nations
The Natural History of Birds
Handbook to the Special Loan Collection of Scientific Apparatus
The Sandmans Mountain a Story for Large Persons to Read to Small Persons
Honours Worth or the Cost of a Vow Vol 2 of 2 A Novel
The Virginians Vol 2 of 4 A Tale of the Last Century
History of the Bank of England Vol 1 Its Times and Traditions
Rochester Ford The Story of a Successful Christian Lawyer
The American Book-Keeper
The Syntax of the Genitive Case in the Lindisfarne Gospels Vol 1
A Womans Story Vol 1 of 3
Law and Lawyers Vol 2 of 2 Or Sketches and Illustrations of Legal History and Biography
The Chemical News Vol 4 And Journal of Physical Science (With Which Is Incorporated the Chemical Gazette) a Journal of Practical Chemistry in All Its Applications to Pharmacy Arts and Manufactures
Sophocles The Seven Plays in English Verse
Sir Paul Pindar and Other Plays
Married Womens Work 1915 Being the Report of an Enquiry Undertaken by the Womens Industrial Council (Incorporated)
Farm Boys and Girls
Health at Its Best V Cancer
A Womans Error Vol 2 of 2 A Novel
The Earlier English Water-Colour Painters
Political Deceptions and Delusions
Screws and Screw-Making With a Chapter on the Milling Machine
Trees A Handbook of Forest Botany for the Woodlands and the Laboratory Vol 5
The Lives of the Most Eminent British Painters and Sculptors Vol 5 of 5
History of the People of England Vol 1
Canadian Kodak Co Limited Trade Circular Vol 14 1918-1920
The Normal Elementary Algebra Containing the First Priniples of the Science Developed with Conciseness and Simplicity for Common Schools Academies Seminaries and Normal Schools
Francis Joseph I His Life and Times an Essay in Politics
The Royal Natural History Vol 5 Section IX
Lessons Introductory to the Modern Higher Algebra
Vivisection Scientifically and Ethically Considered in Prize Essays
A Textbook on Plumbing Heating and Ventilation
Malaria and Its Treatment in the Line and at the Base
The Second Epistle of Paul the Apostle to the Corinthians
Rough Recollections of Military Service and Society Vol 2 of 2
Letters on the Study and Use of Ancient and Modern History Containing Observations and Reflections on the Uses and Consequences of Those Events Which Have Produced Conspicuous Changes in the Aspect of the World and the General State of Human Affairs
Timehri 1913 Vol 3 The Journal of the Royal Agricultural and Commercial Society of British Guiana
New Geography Vol 2
Oedipus on the Sphinx of the Nineteenth Century or Politico-Polemical Riddles Interpreted
German Memories
Schiller-Goetheschen Xenien Die
Report of the International Meteorological Congress Vol 2 Held at Chicago Ill August 21-24 1893 Under the Auspices of the Congress Auxiliary of the Worlds Columbian Exposition
The Medical Language of St Luke A Proof from the Internal Evidence That the Gospel According to St Luke and the Acts of the Apostles Were Written by the Same Person and That the Writer Was a Medical Man
La Vera Antichita Di Pozzuolo
Woods Medical and Surgical Monographs Vol 6
The Life of William Shakespeare Including Many Particulars Respecting the Poet and His Family Never Before Published
Year Book of the Central Conference of American Rabbis Vol 22 Containing the Proceedings of the Convention Held in Baltimore Maryland April 12 to 17 1912
Adventures in Mashonaland
Remarkable Voyages and Travels Consisting of Ansons Voyages Round the World Stephens Incidents of Travel in Greece Turkey Russia and Poland And Koempfers Account of Japan
Chapters on Human Love
Shooting and Salmon Fishing and Highland Sport
Three Brides Vol 1 of 2
The Kickleburys Abroad A Legend of the Rhine Rebecca and Rowena The Second Funeral of Napoleon
Geographical Studies Professor Carl Ritter of Berlin
The Finish to the Adventures of Tom Jerry and Logic in Their Pursuits Through Life in and Out of London
Recollections of a Scottish Novelist
Art in America Vol 6
Professional Papers of the Corps of Royal Engineers Vol 25 1899
Song-Tide Poems and Lyrics of Loves Joy and Sorrow
Battles of the Nineteenth Century Vol 1
Women of All Nations A Record of Their Characteristics Habits Manners Customs and Influence
Twenty Years in the Near East
Letters Literary and Theological of Connop Thirlwall Late Lord Bishop of St Davids
The Art of Dyeing Cleaning Scouring and Finishing on the Most Approved English and French Methods Being Practical Instructions in Dyeing Silks Woollens and Cottons Feathers Chips Straw Etc Scouring and Cleaning Bed and Window Curtains Carpet
The Life and Writings of Miguel de Cervantes Saavedra With Literary and Historical Illustrations from Authentic Documents Supplied by Spanish Biographers and Other Editors of His Works
The Art of Latin Poetry Founded on the Work of M C D Jani
Daniel or the Apocalypse of the Old Testament
Thirty Years of My Life on Three Continents Vol 2 of 2 With a Chapter on the Life of Women in the East
Zigzag Journeys on the Mississippi From Chicago to the Islands of the Discovery
The Evil Genius Vol 2 of 3 A Domestic Story
The History of the British Empire in India Vol 4 of 4
Footprints of the Apostles as Traced By Saint Luke in the Acts Vol 1 of 2 Being Sixty Portions for Private Study and Instruction in Church a Sequel to Footprints of the Son of Man
Joshua Humble a Tale of Old St Louis
Vermischte Schriften Des General-Feldmarschalls
Practical Physiological Chemistry
Friedrich Froebels Pedagogics of the Kindergarten Or His Ideas Concerning the Play and Playthings of the Child
Alumnae Recorder June 1893
The Entomologist Vol 3
A Red Cross Chapter at Work
The Tusculan Questions of Marcus Tullius Cicero in Five Books I Contempt of Death II Bearing Pain III Alleviation of Sorrow IV Perturbations V Virtue Sufficient for Happiness
Scenes and Tales of Country Life with Recollections of Natural History
Spanish and Portuguese Romances of Chivalry The Revival of the Romance of Chivalry in the Spanish Peninsula and Its Extension and Influence Abroad
Notizie Istoriche Degli Intagliatori Vol 3
The Jewish Historical Society of England Transactions Sessions 1902-1905
Biblical Psychology Vol 1 of 4
Pierre Et Jean Vol 2
The Stentor Vol 26 October 7 1911 June 20 1912
The Elements of Physiology for Schools
The 1915 Instano Vol 4 Class of Nineteen Hundred Fifteen
A Students History of England Vol 2 From the Earliest Times to 1885 A D 1509-1689
Laws of the State of Mississippi
Pauli Kitaibelii Additamenta Ad Floram Hungaricam E Manuscriptis 80 I II III IV Oct Lat de Plantis Hungariae Mus Nat Hung
An Inquiry Into the Causes of the General Poverty and Dependence of Mankind Including as Full an Investigation of the Corn Laws
Smithsonian Physical Tables
A Latin Reader Adapted to Bullionss Latin Grammar and to Bullions and Morriss Latin Grammar
An Introduction to the Study of Biological Chemistry
The Child and His Book Some Account of the History and Progress of Childrens Literature in England
Elegant Extracts Vol 6 Being a Copious Selection of Instructive Moral and Entertaining Passages from the Most Eminent Prose Writers Book XI XII Miscellaneous Chronology C
Simplified Infant Feeding With Seventy-Five Illustrative Cases
Scotch Marriages Vol 1 of 3
Life of Principal Harper D D
New Curiosities of Literature and Book of the Months Vol 2 of 2
The Invisible Gentleman Vol 3 of 3
Making Fate
The Border Antiquities of England and Scotland Vol 2 Comprising Specimens of Architecture and Sculpture and Other Vestiges of Former Ages Accompanied by Descriptions Together with Illustrations of Remarkable Incidents in Border History and Tradition
Rhymes of Culture Movement and Repose
The Spirit of English Tragedy
The Prince of Carency A Novel
The History of Myself and My Friend Vol 4 of 4 A Novel
Every Mans Monitor or the Universal Counsellor in Prose and Verse Being a Collection of Select Sentences Choice Maxims and Divine Precepts Suited Both Youth and Age of Every Sect and Denomination as Long as Time Endures
Alicia de Lacy Vol 2 of 4 An Historical Romance
Tremordyn Cliff Vol 2 of 3
Frost and Thaw Vol 2 of 2 A Story with a Moral
The Budget of the Bubble Family Vol 3 of 3
The Life and Letters of Robert Collyer Vol 2 of 2 1823 1912
The Intellectual Giant Roosevelt the Peoples Champion for Human Rights Covering Every Phase of the Most Vital Questions of the Day Including Biographies of Roosevelt and Johnson Candidates for President and Vice President The Platform How Conventi
The Baronet Rag-Picker A Story of Love and Adventure
Stretton Vol 1 of 3 A Novel
Bole Ponjis Vol 1 Containing the Tale of the Buccaneer A Bottle of Red Ink The Decline and Fall of Ghosts And Other Ingredients
Caleb Stukely Vol 1 of 3
Samson Piece En Quatre Actes Representee Pour La Premiere Fois Sur Le Theatre de la Renaissance Le 6 Novembre 1907
Annals of the General Assembly of the Church of Scotland from the Final Secession in 1739 to the Origin of the Relief in 1752 With an Appendix of Biographical Sketches Illustrative Documents and Notes
Arrians History of Alexanders Expedition Vol 1 of 2 Translated from the Greek with Notes Historical Geographical and Critical
The Craftsman Vol 1 October 1901-March 1902
Penn the Statesman and Gulielma A Quaker Idyll
My Irish Year
Revival Hymns
Galerie Des Mollusques Ou Catalogue MThodique Descriptif Et Raisonn Des Mollusques Et Coquilles Du Musum de Douai Vol 2
The Rise of Louis Napoleon
An Open Creel
Miscellaneous Tracts
The Czar Vol 1 of 3 Ivan Vassilivitch the Terrible
The Caged Lion
Western Field Vol 12
Proceedings of the Society of Biblical Archaeology Vol 28 January to December 1906 Thirty-Sixth Session
Ednas Secret Marriage or Loves Champion
Biblical Commentary on the Proverbs Vol 2
Mount Sorel Or the Heiress of the de Veres
Applied Science Vol 7 Incorporated with Transactions of the University of Toronto Engineering Society November 1912 to April 1913
Black But Comely or the Adventures of Jane Lee Vol 1 of 3
The Laird of Norlaw Vol 2 of 3 A Scottish Story
In the Field (1914-1915) The Impressions of an Officer of Light Cavalry
The Rhythm of Life
The Young Heiress Vol 1 of 3 A Novel
Christianity and Modern Culture An Essay in Philosophy of Religion
The Lost Inheritance Vol 1 of 3 A Novel
Darby and Joan
What Is Man?
Memories of Old Salem
The Theosophical Quarterly Vol 19
Gems of Heavenly Wisdom From the Writings of Swedenborg
Britain in Arms
Recollections of Dublin Castle of Dublin Society
The French Revolution and Modern French Socialism A Comparative Study of the Principles of the French Revolution and the Doctrines of Modern French Socialism
God and the King
The Story of the People of England Vol 1 In the Nineteenth Century 1800-1835
Insect Artizans and Their Work
Essays in London and Elsewhere
The Making of Europe A Geographic Treatment of the Historical Development of Europe
Nicholson on Factory Origanization and Costs
The Ambassadors Wife Vol 3 of 3
The Venetians Vol 3 A Novel
The Rise and Fall of Krugerism A Personal Record of Forty Years in South Africa
The Old Chelsea Bun-House A Tale of the Last Century
Forty Years in Brazil
Life and Religion of the Hindoos With a Sketch of My Life and Experience
Wait for the End Vol 2 of 3 A Story
The Pedagogue at Play
Getting Together Essays by Friends in Council on the Regulative Ideas of Religious Thought
Noontide Essays
The Natives of South Africa Their Economic and Social Condition
Towards Morning
The Pastors Fire-Side Vol 1 of 2 A Novel
Taxation in New York State
A Mere Chance Vol 1 A Novel
A Popular Introduction To the History of Christian Doctrine
The History of Women from the Earliest Antiquity to the Present Time Vol 2 of 2 Giving an Account of Almost Every Interesting Particular Concerning That Sex Among All Nations Ancient and Modern
Crossed Swords A Canadian-American Tale of Love and Valor
The Lonely Way Intermezzo Countess Mizzie Three Plays
Castles and Abbeys of England in Poetic and Romantic Lore
The Journal of the Horticultural Society of London 1851 Vol 6
Dr MMillans Formulas and Domestic Guide
Old Memories Vol 3 A Novel
God and the Supernatural A Catholic Statement of the Christian Faith
The Mysterious 3
Dramatic Works Vol 1 of 2
Where We Live and What We Do
Honest Business Right Conduct for Organisations of Capital and of Labour
Humanity and Its Problems
Althea Dialogues on Aspirations Duties
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The Revolutionary Plutarch Vol 1 Exhibiting the Most Distinguished Characters Literary Military and Political in the Recent Annals of the French Republic The Greater Part from the Original Information of a Gentleman Resident at Paris
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Memoir of Joseph Hardcastle Esq First Treasurer of the London Missionary Society A Record of the Past for His Descendants
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Who Goes There
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Questions and Answers on Municipal Law Containing about One Thousand of the Most Important Questions Propounded to Law Students Both at the New York Supreme Court and Columbia Law School Examinations
The Breaking-Point A Novel
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An Elementary Grammar of the German Language Combined with Exercises Readings and Conversations
Incunabulic Treasures and Medieval Nuggets from the Trivulzio Library of Milan Italy Including Vellum Manuscripts of the Thirteenth to Seventeenth Centuries Illuminated with Painted Miniatures Floriated Borders and Initials in Gold and Colors
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Street Railway Locations Granted by the Board of Aldermen to November 1 1895
Extracts from Cicero Narrative and Descriptive with English Notes
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Transactions of the American Society of Heating and Ventilating Engineers Vol 16 Sixteenth Annual Meeting New York January 18-20 1910 Summer Meeting St Louis Mo June 30-July 1
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In the War with Mexico A Midshipmans Adventures on Ship and Shore
Modern Biologic Therapeusis A Concise and Practical Treatise on Biologic Products for the Use of Practitioners in the Modern Application of Immunology to Therapeutics
The Stronger Like Falling Leaves Sacred Ground
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Annual Report of the Receipts and Expenditures of the City of Dover for the Municipal Year 1902 Together with Department Reports and Papers Relating to the Affairs of the City
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North Country Wills Being Abstracts of Wills Relating to the Counties of York Nottingham Northumberland Cumberland and Westmorland at Somerset House and Lambeth Palace 1383 to 1558
Smoleys Tables Parallel Tables of Logarithms and Squares Angles and Logarithmic Functions Corresponding to Given Bevels and Other Tables for Engineers Architects Etc
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Fifth Annual Report of the Municipal Government of the City of Rochester N H for the Financial Year 1896 Together with the City Ordinances
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Michigan Nisi Prius Cases Decided by the State and Federal Courts in Michigan To Which Are Added Brief Biographical Sketches of the Judges of Michigan Past and Present Law Anecdotes and Reminiscences
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A New Pantheon or Fabulous History of the Heathen Gods Heroes Goddesses C Explaind in a Manner Intirely New and Renderd Much More Useful Than Any Hitherto Publishd on This Subject
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Heralds of a Liberal Faith Vol 4 The Pilots
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The Bedrock of Health Based on the Anti-Collaemic Radical Cure of Diseases and Chronic Disorders A New Curative System Founded on the Successful Results of Modern Scientific Research and Practical Experience Lucidly Delineated for the Purpose of Self-T
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So Very Human Vol 1 of 3 A Tale of the Present Day
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Martello Tower in Chin and the Pacific In H MS Tribune 1856-60
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The Works of Christopher Marlowe With Notes and Some Account of His Life and Writings by the REV Alexander Dyce
Torreya Vol 17
From the Crusades to the French Revolution A History of the La Tremoille Family
The Archaeology of Rome Vol 12 The Catacombs
Art and Ireland
Lily White A Romance
Message of the East Vol 5
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subset: commoncrawl


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Pretty Woman (1990)
4 quotes
Directed by: Garry Marshall
Starring: Amy Yasbeck, Hector Elizondo, Jason Alexander, Julia Roberts, Laura San Giacomo, Ralph Bellamy, Richard Gere
Movie Quote QuizMore movie quotes
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When worlds collide spongebob bc dinosaur
by Kazrasar
The song montage features scenes from SpongeBob B.C. and "SB 'Er Indoors - Johnny Hawksworth [Patchy riding a fake dinosaur/Patchy talks about prehistoric times] When Worlds Collide - Theo Mondle, Paul Tibbitt, Kent Osborne. [cut to a screen reading "SpongeBob B.C."] SpongeBob SquarePants B.C.! The dinosaur walks over to a wall where there a cave drawings of Sponge and .. and the robot is DJ-ing, as strobe lights go off]; Song: "When Worlds Collide". Spongebob B.C. Spongebob B.C. [originally aired March 5, ] [we pan Patchy, in leopard garb, comes in riding a paper-mache dinosaur] .. Robot: When worlds collide, you'll laugh so hard, [cut to cave drawings of.
'Er Indoors - Johnny Hawksworth (Patchy riding a fake dinosaur) When Worlds Collide - Theo Mondle, Paul Tibbitt, Kent Osborne [original. SpongeBob: I think that a pirate and a parrot are arguing about me! Patchy a reward, having the robot and caveman sing When Worlds Collide. the T-Rex and tells us, Well, Thanks for watching SpongeBob B.C. and then.
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Chairman of the British Institute of Human Rights. Bindman is also a professor of law at University College London. He has practiced law for over 40 years. He has participated as a jurist on multiple international human rights missions around the world, including in Israel, Palestine and South Africa.