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Gout (Risk Factors & Aetiology (Renal causes (High insulin levels…
Gout
Risk Factors & Aetiology
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High fructose intake (sugary drinks, cakes, sweets and fruit sugars) - reduces uric acid secretion
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Clinical Presentation
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Gout also increases the risk of hypertension, renal disease, CVS disease, type 2 diabetes and osteoarthritic damage to joints
Acute gout
Sudden onset of agonising pain, swelling and redness of the first MTP joint - BIG TOE
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Attack may be precipitated by excess food (esp. red meat), alcohol, dehydration, or diuretic therapy, cold, trauma or sepsis
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Treatment
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Acute gout
If not tolerated/contraindicated, use colchicine (targets uric acid formation)
IM, oral or intra-articular corticosteroid e.g. prednisolone
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Aim to get the uric acid level down below normal in blood so crystal reverse and start to increase uric acid levels down to below 300
Pathophysiology
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You need hyperuricaemia to develop gout, but being hyperuriaemic doesn't mean definitely having gout
Purines are consumed from food, and as part of their excretion they are converted to uric acid
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Key Facts
An inflammatory arthritis that is associated with hyperuricaemia (high levels of uric acid) and intra-articular monosodium rate crystals
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