Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Gout Presentation

17,605 views

Published on

  • Vitiligo Miracle Video - Heal Vitiligo In 7 Days ➣➣➣ https://bit.ly/3kTNHDZ
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Heal Vitiligo In 21 Days? ▶▶▶ http://tinyurl.com/y4d5dqxj
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • I like this service ⇒ www.WritePaper.info ⇐ from Academic Writers. I don't have enough time write it by myself.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • I like this service ⇒ www.HelpWriting.net ⇐ from Academic Writers. I don't have enough time write it by myself.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Hi there! I just wanted to share a list of sites that helped me a lot during my studies: .................................................................................................................................... www.EssayWrite.best - Write an essay .................................................................................................................................... www.LitReview.xyz - Summary of books .................................................................................................................................... www.Coursework.best - Online coursework .................................................................................................................................... www.Dissertations.me - proquest dissertations .................................................................................................................................... www.ReMovie.club - Movies reviews .................................................................................................................................... www.WebSlides.vip - Best powerpoint presentations .................................................................................................................................... www.WritePaper.info - Write a research paper .................................................................................................................................... www.EddyHelp.com - Homework help online .................................................................................................................................... www.MyResumeHelp.net - Professional resume writing service .................................................................................................................................. www.HelpWriting.net - Help with writing any papers ......................................................................................................................................... Save so as not to lose
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Gout Presentation

  1. 1. GOUT
  2. 2. What is Gout? • Crystal arthritis • Deposition of uric acid crystals in joints • Presents with acute monoarticular arthritis in 90 % of patients. • Men > Women • Onset 40-60 years • Very treatable • Untreated, may lead to chronic tophaceous gout.
  3. 3. History • Pain, swelling and redness of affected joint • Pain exacerbated by movement • May be pyrexial • Podagra is initial presentation in 50 % cases. • Starts abruptly, max intensity within 8-12 hours. • Resolves spontaneously < 2 weeks
  4. 4. Uric Acid Metabolism Nucleic Acids Hypoxanthine Xanthine Uric Acid Xanthine Oxidase Xanthine Oxidase Excretion by Kidney
  5. 5. What goes wrong? Nucleic Acids Hypoxanthine Xanthine Uric Acid Xanthine Oxidase Xanthine Oxidase Excretion by Kidney GOUT Impaired renal excretion Increased nucleic acids
  6. 6. Predisposing Factors • Gender- male > female • Family History • Previous attack • Body size - large > small • Alcohol • Diet – purine rich • Diuretics • Causes of high cell turnover e.g. psoriasis, chemotherapy • Renal insufficiency
  7. 7. What happens in the joint? • Supersaturation leads to urate crystal deposition within joint. • Leads to inflammatory response → Symptoms
  8. 8. Investigations • Joint aspiration - polarising light microscopy for crystals • FBC - white cells raised • ESR - raised • X-ray - generally normal • Serum urate HIGH SERUM URATE DOES NOT NECESSARILY MEAN THE PATIENT HAS GOUT!
  9. 9. Treatment of Acute Attack • NSAID • Colchicine – GI side effects, – Most effective in 1st 24 hours • Corticosteroid – If NSAID and colchicine contraindicated AIM- to reduce symptoms
  10. 10. Prevention of Further Attacks • Lifestyle changes – to minimise risk factors • Drug therapies – Xanthine oxidase inhibitors e.g. Allopurinol – Uricosuric agents e.g. Probenecid • Need to be taken for life • Can precipitate an acute attack therefore give together with NSAID or colchicine for 2 months. AIM - Prophylaxis
  11. 11. Site of drug action Nucleic Acids Hypoxanthine Xanthine Uric Acid Xanthine Oxidase Xanthine Oxidase Excretion by Kidney Uricosuric agents e.g. Probenecid XO inhibitors e.g. Allopurinol GOUT
  12. 12. Chronic Tophaceous Gout • If gout untreated • Other joint involvement • Formation of tophi- collection of crystals in soft tissues • Bone erosion at joints- ‘punched out’ erosions on x-ray.
  13. 13. Tophi
  14. 14. X-rays
  15. 15. Key Points • Gout is due to deposition of urate crystals in joints leading to inflammation. • Diagnosis is by history and polaroid microscopy of synovial fluid. • High serum uric acid does NOT mean the patient has gout. • Gout is one of the most treatable arthritic conditions. • Treat acute attack and then consider prophylaxis of future episodes. • If untreated, can develop into chronic tophaceous gout.
  16. 16. Summary • Many predisposing/risk factors • Typical history • Investigations • Treatment - understanding of uric acid metabolism • Chronic tophaceous gout
  17. 17. References • Francis M, 2006. eMedicine - Gout. http://www.emedicine.com/med/topic924.htm. Accessed 10/2/2007 • Andrew J, Herrick A and Marsh D. Musculoskeletal Medicine and Surgery. Churchill Livingstone, London 2000. • Underwood J. General and Systemic Pathology Third Edition. Churchill Livingstone, 2003

×