Mr. Grady, a 70-year-old male with a history of arthritis, is evaluated by his rheumatologist for a sudden onset of excruciating pain and classic symptoms of gout in the first metatarsal joint of the left great toe. He appears at the office using crutches to avoid bearing weight on his left foot. His vital signs are temperature 100.6, pulse 88, respirations 28, and blood pressure 164/92. He describes the level of his pain at 10 when not at rest. Mr. Grady’s left toe appears inflamed and is very tender to the touch. Diagnostic evaluation turns up urate crystals in the joint fluid, and a blood serum uric acid test indicates hyperuricemia. Mr. Grady mentions he and his wife have just returned from a cruise celebrating their fiftieth wedding anniversary. He states that he enjoyed lots of his favorite foods, including shrimp and steak, and that he drank a great deal of beer. His more recent medical history includes increasing obesity, poorly controlled high blood pressure, and kidney stones. The doctor notes that his daily medications include low-dose aspirin therapy and a diuretic (Dyazide). 1. Describe the pathology of gout. 2. What classic symptoms and signs of gout does Mr. Grady exhibit? 3. What could be expected as the medical treatment plan for Mr. Grady?
Mr. Grady, a 70-year-old male with a history of arthritis, is evaluated by his rheumatologist for a sudden onset of excruciating pain and classic symptoms of gout in the first metatarsal joint of the left great toe. He appears at the office using crutches to avoid bearing weight on his left foot. His vital signs are temperature 100.6, pulse 88, respirations 28, and blood pressure 164/92. He describes the level of his pain at 10 when not at rest. Mr. Grady’s left toe appears inflamed and is very tender to the touch. Diagnostic evaluation turns up urate crystals in the joint fluid, and a blood serum uric acid test indicates hyperuricemia.
Mr. Grady mentions he and his wife have just returned from a cruise celebrating their fiftieth wedding anniversary. He states that he enjoyed lots of his favorite foods, including shrimp and steak, and that he drank a great deal of beer. His more recent medical history includes increasing obesity, poorly controlled high blood pressure, and kidney stones. The doctor notes that his daily medications include low-dose aspirin therapy and a diuretic (Dyazide).
1. Describe the pathology of gout.
2. What classic symptoms and signs of gout does Mr. Grady exhibit?
3. What could be expected as the medical treatment plan for Mr. Grady?
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