*Gout

Question 1

Age

Answer 1

over 30 y/o

For women, 15 yrs post menopausal

Question 2

Male/Female/Race

Answer 2

Males (<90%)

Question 3

Family History

Answer 3

Positive

Question 4

Health History Risk Factors

Answer 4

1) Renal disorders leading to increased uric acid secretion or decreased excretion
2) Leukemia
3) Lymphoma
4) Psoriasis
5) chemotherapy
6) hypothyroidism
7) heavy alcohol consumption
8) diuretics
9) levadopa
10) hypertension
11) diet rich in purines (shellfish)

Question 5

History of symptoms

Answer 5

Abrupt onset

Often at night

Question 6

Location of symptoms

Answer 6

80% in LE of which 50% involve 1-MTP

Also, ankle, MTJ, knee, wrist and elbow, and fingers

Question 7

Symptom description

Answer 7

Exquisite pain- acute onset

Question 8

Aggravating Factors

Answer 8

Movement

weight bearing

Question 9

Alleviating Factors

Answer 9

Non-weightbearing

Joint protection

Question 10

24 hour report

Answer 10

when chronic- AM stiffness pronounced

Question 11

Review of systems

Answer 11

fever may be present

Question 12

ROM/mobility

Answer 12

severe loss

Question 13

Palpation/observation

Answer 13

Joint warmth

Redness/edema

Extreme tenderness

Question 14

Complications

Answer 14

Acute phase- joint protection measures

Question 15

Lab Tests

Answer 15

Synovial fluid- presence of monosodium urate crystals

Question 16

Diagnostic Imaging

Answer 16

Erosion of margins

Osteoporosis

Partial preservation of joint space

Question 17

Clinical Findings for diagnosis

Answer 17

1) fever
2) chills
3) Tachycardia
4) warm, red, swollen joint without injury