Exam 1 Material: Gout

Question 1

What is Gout?

Answer 1

Most common inflammatory arthritis.

Systemic disease caused by a disruption in purine metabolism which causes uric acid crystals to form in the joints. This causes inflammation and pain.

Question 2

True or false. Gout flare ups can last for days or weeks.

Answer 2

True.

Question 3

True or false. Gout can be asymptomatic for years.

Answer 3

True.

Question 4

What are the risk factors for developing Gout?

Answer 4

Obesity or starvation

Excessive alcohol use

DM; Renal impairment, Hyperlipidemia, HTN

Acidosis or Ketosis

Chemotherapy, thiazide diuretics, aspirin

Sickle Cell disease

Malignancy.

Question 5

What diagnostic tests should be done for Gout?

Answer 5

Serum Uric acid levels, 24-hour urine for uric acid

X-ray

Synovial fluid aspiration (gold standard to diagnosis Gout)

Clinical manifestations.

Question 6

What are the expected findings for Acute Gout?

Answer 6

Usually starts due to events like trauma, surgery, alcohol intake or infection.

Involves 1 to 3 joints.

Symptom onset occurs at night and gets worse with sudden swelling and severe pain.

Low grade fever

Acute attacks can subside in 2-10 days with or without treatments

Great toe is the most common site of initial gout attack

Question 7

What are the expected findings of Chronic Gout?

Answer 7

Multiple joint involvement

Visible deposits of sodium urate crystals = Tophi

Joint deformity

Nephrolithiasis = uric acid stones (kidney stones due to bulld up of uric acid.

Question 8

What lab values would indicate Gout?

Answer 8

Elevated serum uric acid

Elevated urinary uric acid

Elevated BUN and Creatinine

Elevated ESR

Question 9

What are the nursing interventions and care for patients with Gout?

Answer 9

Avoid purine rich foods such as alcohol, shellfish, spinach and red meats in order to prevent increased production of uric acid.

Medical Therapy

Adequate fluid intake to prevent kidney stone buildup due to excess uric acid.

Hot and Cold Therapy

Joint immobilization

Use stress-management techniques.

Question 10

What medications are used for managing Gout?

Answer 10

For Acute Exacerbation of Gout attacks, the medicine used are

NSAIDS (Pain relief)

Prednisone ( anti-inflammatory)

Colchicine (Anti-gout agent. Used to decrease pain and inflammation)

For chronic Gout, medication used is

Allopurinol (Promote uric acid excretion and decrease its production)