Question

A 65-year-old male presented with severe pain in his left thumb and right big toe, which was accompanied by inflammation and erythema of the joints. The client had previously been diagnosed with acute gouty arthritis approximately 5 years ago but had not experienced another acute attack since his original diagnosis. The patient had been steadily gaining weight over the last few years and was now about 50 lbs overweight. He stated that he drinks about a six-pack of beer every day.

1. What are the three lab tests the doctor will order to determine if the client is having a flare-up of his Gout?  

2. If the client is having a flare-up of gout what would you anticipate the results of the lab tests identified in question 1 to be?

3. What are three lifestyle modifications you could suggest to help the client with his gout?

Answer 1

1. LABORATORY TEST FOR GOUT--

a) ASPIRATION OF JOINT FLUID Here in this case aspiration is taken from left thumb and right big toe.

b) BLOOD TEST- serum uric acid is noticed.

c) X ray of the joint . Here the x ray or radiography is done of left thumb and right big toe.

2.ANTICIPATE THE RESULTS--

a) In aspiration of joint fluid and when the fluid is examined under microscopy. There will be seen mono sodium urate crystals which are needle shaped .

b) In blood test examination there will be seen hyperuricemia means increased serum uric acid level( >7 microgram/dL). Normal range of uric acid is 3.5 to 7 micrograms per dL.

c)In Xray or radiology findings , there will be overhanging or G sign radiogram is seen due to joint destruction and formation of punched out lesions.

3.Lifestyle modifications --

a) Limit the intake of alcohol beverages and drinks. Here in this case the risk factors of raised uric acid level is due to alcohol.

b) Avoid red meat, sea food. Red meat, sea food increases production of uric acid which is cause of gout.

c) increase vitamin c intake such as citrus fruit ( lemon, orange), spinach, papaya in your diet.

d) increase fluid intake of water, non alcoholic beverages

avoid medication like aspirin, diuretics as these interferes with uric acid production means have a role in decreased uric acid excretion  from body.