GOUT

Question 1

Elevation of uric acid

Answer 1

Gout

Question 2

deposit of uric acid crystals in one or more joints

Answer 2

Gout

Question 3

sodium urate crystals

Answer 3

Gout

Question 4

painful flares lasting days to weeks followed by long periods without symptoms

Answer 4

Gout

Question 5

What is gout

Answer 5

-Elevation of uric acid
-deposit of uric acid crystals in one or more joints
-sodium urate crystals
-painful flares lasting days to weeks followed by long periods without symptoms

Question 6

Etiology of Gout

Answer 6

-Heredity
-Medications
-Prolonged fasting or excessive alcohol

Question 7

Etiology of Gout in heredity

Answer 7

-primary hyperuricemia

Question 8

Etiology of Gout in medications

Answer 8

-secondary hyperuricemia
- inhibit uric acid excretion
- examples: loop diuretics; b blockers

Question 9

what happens to the condition of gout if there is a prolonged fasting and excessive alcohol

Answer 9

increase the production of keto acids; inhibit uric acid excretion

Question 10

What is the Pathophysiology of Gout?

Answer 10

-Crystallization and inflammation
-Metabolic syndrome

Question 11

Explain the crystallization and inflammation in the pathophysiology of Gout

Answer 11

-saturation of the synovial fluid or soft tissues by urates
-urates coalesce crystals
-inflammatory mediators are released

Question 12

what are the metabolic syndrome?

Answer 12

-obesity
- insulin resistance
- hypertension
- hyperlipidemia

Question 13

Clinical Manifestations of gout

Answer 13

Chronic Gout

Question 14

multiple joint involvement

Answer 14

Chronic gout

Question 15

visible deposits of sodium urate crystals

Answer 15

Chronic gout

Question 16

What is chronic gout?

Answer 16

-multiple joint involvement
-visible deposits of sodium urate crystals
-tophi

Question 17

What is tophi?

Answer 17

-visible deposits of sodium urate crystals
-occurs many years after the onset of the disease

Question 18

occurs many years after the onset of the disease

Answer 18

tophi

Question 19

Complications of Gout

Answer 19

-kidney stones
-urinary tract stones
-pyelonephritis

Question 20

what is pyelonephritis?

Answer 20

sodium urate deposits

Question 21

Diagnostics of Gout

Answer 21

-History and physical examination
-Elevated serum uric acid levels
-Elevated uric acid levels in 24-hr urine collection
-Preradiographic studies
-Synovial fluid aspiration

Question 22

What is the gold standard diagnostic of Gout?

Answer 22

Synovial fluid aspiration

Question 23

Nutritional Management of Gout

Answer 23

-dietary avoidance of food and fluids with high purine content

Question 24

Examples of high purine content foods

Answer 24

-anchovies
-liver
-wine
-beer

Question 25

What are the medical management of Gout

Answer 25

-Colchicine -Xanthine oxidase inhibitor - Selective xanthine oxidase inhibitor - Uricosurics - Corticosteroids -NSAIDs

Question 26

Anti-inflammatory; no analgesics properties

Answer 26

Colchicine

Question 27

this drug can be combined with NSAIDs

Answer 27

Colchicine

Question 28

Pain relief of colchicine

Answer 28

Pain relief within 12 hours of an attack

Question 29

This drug is hepatotoxic and nephrotoxic

Answer 29

Colchicine

Question 30

What is colchicine?

Answer 30

-anti-inflammatory; no analgesics properties - combined with NSAIDs - given orally - pain relief within 12 hours of an attack - hepatotoxic and nephrotoxic

Question 31

urate lowering medication

Answer 31

xanthine oxidase inhibitor

Question 32

What is the role of xanthine oxidase inhibitor?

Answer 32

prevents future attacks of gout

Question 33

example of xanthine oxidase inhibitor drug

Answer 33

Allopurinol (Zyloprim)

Question 34

What is xanthine oxidase inhibitor?

Answer 34

-urate-lowering medication - prevents future attacks of gout - given orally -Allopurinol (Zyloprim)

Question 35

This drug is given for long term management for chronic gout

Answer 35

Selective xanthine oxidase inhibitor

Question 36

Example of selective xanthine oxidase inhibitor drug

Answer 36

Febuxostat (Uloric)

Question 37

What is selective xanthine oxidase inhibitor?

Answer 37

-given for long term management for chronic gout -taken orally -Febuxostat (Uloric)

Question 38

This drug enhances uric acid secretion in the urine

Answer 38

Uricosurics

Question 39

This drug prevents attacks; does not cure gout

Answer 39

Uricosurics

Question 40

Example of Uricosurics drug

Answer 40

Probenecid (Benuryl)

Question 41

What is Uricosurics?

Answer 41

-enhances uric acid secretion in the urine -prevents attacks; does not cure gout -given orally -Probenecid (Benuryl)

Question 42

this drug is anti-inflammatory

Answer 42

corticosteroids

Question 43

Corticosteroids can be given in what?

Answer 43

Corticosteroids can be given either orally or by intra-articular injection

Question 44

Example of corticosteroids drug

Answer 44

Prednisone (Prolix)

Question 45

what is corticosteroids?

Answer 45

-Anti-inflammatory -given either orally or by intra-articular injection

Question 46

Example of NSAIDs drug

Answer 46

Naproxen (Naprosyn)

Question 47

Nursing Management of Gout

Answer 47

-pain management - warm compress - cold compress - bed rest to immobilize affected joint

Question 48

Purpose of warm compress in the management of gout

Answer 48

done between attacks to reduce general pain and stiffness

Question 49

Purpose of cold compress

Answer 49

done during attacks to relieve pain and inflammation

Question 50

how many minutes to use cold compress?

Answer 50

20-30 mins