Gout

Question 1

Demographics of Gout:

Answer 1

2% incidence
Men > 30 and Women > 50
Common in Maori, PI and African American
BMI > 30

Question 2

Aetiology of Gout:

Answer 2

• Renal doesn’t excrete enough Uric acid causing hyperuricemia (90%)
• High Uric acid production (10%)
• Genetics (60%)

Question 3

Signs and Symptoms of Gout:

Answer 3

Pain that comes and goes in the 1 MTP joint with inflammation

Question 4

Diagnosis of Gout:

Answer 4

• High concentrations of uric acid in blood

- See Crystals in MTP joint (high erythrocyte sedimentation rate)

Question 5

Pathophysiology of Gout:

Answer 5

• Uric Acid Crystals in MTP joint

- Renal Caliculi

Question 6

Conventional Therapies for Gout:

Answer 6

• Exercise (when there is no flare up)
• Ice, NSAID’s (anti-inflammatories)
• Reduce Weight
• Reduce intake of meat, fish, alcohol and sugary drinks

Question 7

What is the role of aerobic exercise in rehabilitation of Gout?
(Williams PT study)

Answer 7

• Reduced risk of gout with increased physical activity
• BMI below 27.5 pref. 25
• Eat more fruit and eat less meat, bread and alcohol

Question 8

Why is exercise good for people with Gout:

Answer 8

Because there is evidence that it counteracts the hyperuricaemic effects of obesity and insulin resistance

Question 9

Contraindications to exercise for people with Gout:

Answer 9

• Flare up

Question 10

Exercise Recommendations for people with Gout:

Answer 10

Prescribe for age and fitness level

- Be aware for CVD

Question 11

Acute and Chronic Responses to exercise in people with Gout:

Answer 11

• Improved metabolic function
  Decreased insulin resistance and enhanced kidney function
• Reduced risk of co-morbidities