Scribd Logo
Upload

Welcome to Scribd!

  • 33 views

    The Rich Man'S Disease

    Uploaded by

    Sixtyskills
    Gout is caused by high uric acid levels in the blood (hyperuricemia) which leads to urate crystals forming in joints, often the big toe joint. It causes sudden, severe pain and inflammation. Gout is more common in those with reduced kidney function or who consume foods and drinks high in purines. Treatment involves medications to reduce uric acid levels and relieve pain and inflammation during flare ups. Maintaining hydration and managing other health conditions like high blood pressure are also important for gout treatment and prevention.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    The Rich Man'S Disease

    Uploaded by

    Sixtyskills
    33 views9 pages
    Gout is caused by high uric acid levels in the blood (hyperuricemia) which leads to urate crystals forming in joints, often the big toe joint. It causes sudden, severe pain and inflammation. Gout is more common in those with reduced kidney function or who consume foods and drinks high in purines. Treatment involves medications to reduce uric acid levels and relieve pain and inflammation during flare ups. Maintaining hydration and managing other health conditions like high blood pressure are also important for gout treatment and prevention.

    Original Description:

    Gout and TCM

    Original Title

    Gout presentation

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Gout is caused by high uric acid levels in the blood (hyperuricemia) which leads to urate crystals forming in joints, often the big toe joint. It causes sudden, severe pain and inflammation. Gout is more common in those with reduced kidney function or who consume foods and drinks high in purines. Treatment involves medications to reduce uric acid levels and relieve pain and inflammation during flare ups. Maintaining hydration and managing other health conditions like high blood pressure are also important for gout treatment and prevention.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    33 views9 pages

    The Rich Man'S Disease

    Uploaded by

    Sixtyskills
    Gout is caused by high uric acid levels in the blood (hyperuricemia) which leads to urate crystals forming in joints, often the big toe joint. It causes sudden, severe pain and inflammation. Gout is more common in those with reduced kidney function or who consume foods and drinks high in purines. Treatment involves medications to reduce uric acid levels and relieve pain and inflammation during flare ups. Maintaining hydration and managing other health conditions like high blood pressure are also important for gout treatment and prevention.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 9

    Gout

    “THE RICH MAN’S DISEASE”


    Definition

     Gout is caused by hyperuricemia (serum urate > 6.8 mg/dL) that results in monosodium
    urate crystals in and around joints, most often causing recurrent acute or chronic arthritis.
    The initial attack (flare) of gout often involves the 1st metatarsophalangeal joint.
    Symptoms of gout include acute, severe pain, tenderness, warmth, redness, and swelling.
    Pathophysiology

     Decreased excretion (most common)


     Diuretics and diseases that decrease GFR
     Ethanol increases the formation of lactic acid, which blocks urate secretion by the renal tubules,
    and ethanol may also stimulate liver urate synthesis
     Increased production
     Nucleoprotein turnover in hematologic conditions (lymphoma, leukemia, hemolytic anemia) and
    conditions with increased rates of cellular proliferation/ cell death (psoriasis, cytotoxic cancer
    therapy, radiation therapy)
     Increased purine intake
     purine-rich foods (liver, kidney, anchovies, asparagus, consommé, herring, meat gravies and
    broths, mushrooms, mussels, sardines, sweetbreads)
    Signs/Symptoms

     Metatarsophalangeal joint of a great toe is most often involved


     Instep, ankle, knee, wrist, and elbow
     Initially affect only a single joint and last only a few days
     Tophi develop in patients with chronic gout, but may occur in patients who have never
    had acute gouty arthritis.
     Firm yellow or white papules or nodules
     Chronic gouty arthritis can cause pain, deformity, and limited joint motion. Inflammation
    can be flaring in some joints while subsiding in others.
     20% of patients develop urolithiasis with uric acid stones/calcium oxalate stones.
     Complications of chronic gout include renal obstruction and infection
     Co-morbid conditions include: cardiovascular disease and metabolic syndrome
    Diagnosis

     Acute gout: Arthrocentesis and synovial fluid analysis


     Identify needle-shaped urate crystals that are free in the fluid or engulfed by phagocytes.
     Usually 2,000 to 100,000 WBCs/μL, with > 80% polymorphonuclear WBCs.
     Chronic gout: Diagnostic ultrasonography
     Double-contour sign
    Treatment

     Termination of an acute attack with NSAIDs, colchicine, or corticosteroids

     Prevention of recurrent acute attacks with daily colchicine or an NSAID

     Prevention of further deposition of MSU crystals, reduction in flare incidence, and resolution of
    existing tophi by lowering the serum urate level
     Decease urate production with allopurinol or febuxostat
     Dissolve deposits with pegloticase,
     Increse urate excretion with probenecid or lesinurad

     Treatment of coexisting hypertension, hyperlipidemia, and obesity and sometimes avoidance of


    excess dietary purines
    Other Treatments

     Fluid intake ≥ 3 L/day is desirable for all patients, especially those who chronically pass
    urate gravel or stones.
     Alkalinization of urine (with potassium citrate 20 to 40 mEq po bid or acetazolamide 500
    mg po at bedtime)
     Excessive alkalinization may cause calcium phosphate/oxalate crystals.
     Shock wave lithotripsy may used to disintegrate renal stones.
     Large tophi in areas with healthy skin may be removed surgically; all others should
    slowly resolve under adequate hypouricemic therapy

    You might also like