Question

In: Nursing

YH presents to the clinic with a chief complaint of severe pain, redness, and swelling in...

YH presents to the clinic with a chief complaint of severe pain, redness, and swelling in his joints. Upon further assessment, he has been diagnosed with gout.

a. Explain what is causing YH’s severe joint pain on a biochemical level. Which specific degradation pathway does it relate to?

b. You suspect the patient’s diet might be the primary cause of his gout. What type of diet could contribute to gout? What is another potential cause of gout unrelated to his diet?

c. Allopurinol is the drug of choice to prevent next gout episode. What is its target substrate and how does inhibiting it help to prevent gout? Explain its mechanism of action and how it can help to decrease the patient’s uric acid formation. (hint: there are 2 ways)

Expert Solution

GOUT

It is a common complex form af arthritis which is caudes by increased uric acid in the blood.

a.

The person named YH having severe joint pain it is beacuse,gout is occuring in the joints which is the connection of two bones.In case of gout there will be an increase uric acid level in the bloodstrem due to the decreased excreation of uric acid.This accumulated uric acid will be deposidedas a needle like crystals in the joints and causes inflammation,swelling, and joint pain.

Uric acid is a chemical form when Purines are breakdown.Hypoxanthine from IMP is catalyzed to xanthine, when thre oxidization occurs for the xanthine may lead to the formation of the uric acid.And this formed uric acid will be excreated through the urine or through the alimentary excreation.It is it depositing in the tissue as an excess form will lead to the crystal formation ang gout.

b. Causes of gout

Foods related causes

The high purine foods will cause gout such as

All types of alcoholic beverages
some fishes,seafood and shelfish Eg:Shrimp,tune ,Scallops etc
Some meats such as bacon,turkey and organ meat like liver.
Eating or drinking foods or drinks contain high fractose

Other causes

Gender( more in males)
Obesity
Older age
Alcoholism
Medications such as loops and thiazide diueretics
Renal diseases
Insulin resistance
Hyperglycemia

c.

ALLOPURINOL

Allopurinol is in a class of medications called Xanthine oxidise inhibitors.It is a medicine of choice for the gout patient. Gout is an acute arthritis due to the accumulation of uric acid in the joints as a crystal form.This uric acid is formed in the body through the purine pathway,because uric acid is the end product of purine breakdown through the oxidation of xanthine.Thus, Allopurinol inhibits the xantine oxidation and lead to decrease production of uric acid in the blood stream.

Nightingale answered 11 months ago

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