gout

Question 1

Common in

Answer 1

older men

Question 2

Uric acid metabolism:

• lack of ____
• lack of ability to oxidise _____ to a soluble compound

Answer 2

• lack of uricase

- lack of ability to oxidise uric acid to a soluble compound

Question 3

Uricase is a normal byproduct of the breakdown of foods that contain _____

Answer 3

purines

Question 4

Attack of gout occurs when monosodium urate crystals ______ in the joint and initiate an ____________

Answer 4

precipitate;

an inflammatory response

Question 5

Clinical presentation

• monoarticular, usually first ______ joint
• precipitated by excessive exercise, certain meds or food, alcohol, or dieting — begins at ______
• ______ pain onset, ______, ______
• patient may be ______ in the early stages of gout

Answer 5

• monoarticular, usually first metatarsophalangeal joint
• precipitated by excessive exercise, certain meds or food, alcohol, or dieting — begins at night
• abrupt pain onset, redness, swelling
• patient may be asymptomatic in the early stages of gout

Question 6

Objective of treatment:

Answer 6

correction of hyperuricemia (inhibition of further precipitation of sodium urate, absorption of urate crystal deposits)

Question 7

Avoid what kind of food? Eg?

Answer 7

Purine-rich foods (they produce uric acid)

eg. seafood, red meat, organs, alcohol, aged cheese

Question 8

Medications and their uses

Answer 8

• NSAIDs
• Probenecid: eliminates uric acid
• Allopurinol: reduces production of uric acid

Question 9

Acute attack stage (nur management):

Answer 9

• bed rest with affected extremity elevated
• monitor joint range of motion ability
• position the joint in mild flexion
• provide heat or cold for local treatment to affected joint as prescribed

Question 10

Encourage high fluid intake of ______mL/day to prevent stone formation.

Answer 10

2000