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1 page/≈275 words
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APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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Topic:

Neurological and Musculoskeletal Disorders: Pathophysiology of Gout

Essay Instructions:

Scenario 1: Gout
A 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief.
HPI: hypertension treated with Lisinopril/HCTZ .
SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated.
PE: remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl.
Diagnoses the patient with acute gout.
Question:
Explain the pathophysiology of gout.

Essay Sample Content Preview:

Neurological and Musculoskeletal Disorders-Scenario 1: Gout (Pathophysiology)
Name
Institutional Affiliation
NURS 6501
Instructor
Due Date
Neurological and Musculoskeletal Disorders-Scenario 1: Gout (Pathophysiology)
Uric acid (urate) is the final metabolite of human purine catabolism as there is no enzyme urate oxidase, and most of the uric acid is excreted through the kidney (McCance & Huether, 2018). The decrease in the renal excretion of uric acid is the main mechanism of gout. When gout appears in people, it may be because of an enzymatic defect. Gout is caused by the deposition of monosodium urate (MSU) crystals in joints or tissues (Pascual et al., 2017). Other factors such as pH changes caused by perioperative ketosis, fall in nocturnal body temperature, and dehydration of the joint cause monosodium urate crystal deposition in joints.
Factors that increase the risk of hyperuricemia (elevated uric acid level in the blood) also increase the risk of gout. Thus, modifiable risk factors are prioritized in managing got, such as a high-purine diet, alcohol, obesity, and diuretic use (Paul et al., 2017). Uric acid levels vary by gender, and men have higher serum urate levels at all ages compared to women. However, after menopause, the loss of estrogen causes a reduction in renal excretion of uric acid....
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