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1 page/β‰ˆ275 words
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4 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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MS Word
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Topic:

Pathophysiology of Gout and the Development of Renal Calculi

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 why a patient with gout is more likely to develop renal calculi.

Essay Sample Content Preview:

Neurological and Musculoskeletal Disorders-Scenario 1: Gout and Development of
Name
Institutional Affiliation
NURS 6501
Instructor
Due Date
Neurological and Musculoskeletal Disorders-Scenario 1: Gout and Development of Renal Calculi
Uric acid (urate) is an end product of purine catabolism. The urate concentration is stable at 5 mg/dL in postpubertal males and 4.1 mg/dL in postpubertal females (McCance & Huether, 2018). Unlike most mammals, uric acid product of purine metabolism in humans because the gene encoding the enzyme urate oxidase (UO) is absent. Changes in the normal serum urate levels cause hyperuricemia, and sodium urate crystals get deposited in tissues resulting in gout, representing various painful disorders. Elevated serum urate levels cause sodium urate crystals to accumulate in tissues. At normal physiological pH and body temperature, uric acid concentrations are normal. When there is increased concentration, urate monohydrate crystals deposition happen in the joints.
Chronic hyperuricemia causes urate to be deposited in tissues resulting in cell injury and inflammation, but the urate crystals fail to degrade and are represented in dead cells (McCance & Huether, 2018). Hyperuricemia is one indicator of the risk of gout. Undigested uric acid accumulates within lysosomes and damage...
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