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Gout (code? 10)
Definition Gout is a genetically caused disease (enzymopathy), which is based on an increase in purine synthesis, excessive formation of uric acid, leading to recurrent "crystalline" arthritis, systemic lesions in the form of uric acid nephropathy, urolithiasis, interstitial urate nephritis.
Statistics. Asymptomatic hyperuricemia (above 0.07 g / l - 7.0 mg%) is found in 4-9% of adults. Asymptomatic hyperuricosuria (daily uric acid excretion> 700 mg) is detected even more often - in 8-18% of adults from a random sample. The frequency of the disease is much less common, ranging from 0.4 to 0.6%.
Etiology. Risk factors. A genetic defect is the lack of the enzyme hypoxanthine-guanine phosphorfibrosyl transferase, which leads to an excess of uric acid formation. The second option is the excessive activity of the phosphorosylpyrophosphate amidotransferase enzyme, which also leads to overproduction of uric acid.
Risk group: active men with good appetite, overweight (“gouty personality”, according to Sydenham).
In the genesis of arthritis attacks, primary and secondary (post-traumatic) cartilage pathologies play a large role. Cartilage microtraumas, the release of proteoglycans into the joint cavity, local cooling are factors contributing to the accumulation of urate crystals in the synovial fluid.
Acute attacks of monoarthritis with selective damage to the proximal joint of the big toe are characteristic, more often after physical exertion or excessive
consumption of alcohol and overeating. The duration of the acute phase is from 4 hours to 2 days. The following radiological symptoms are characteristic of gout: round stamped defects (“punches”) in the pineal glands surrounded by a “sclerotic border”; racemose defects that destroy the cortical layers ("bone tofus"); thickening of soft tissues due to the deposition of urate.
Chronic gouty arthritis is characterized by a protracted course of arthritis, deposits of urate in the joint bag, synovial membranes. Tofuses are most often found around joints on the ulnar surface of the forearm, on the Achilles tendon.
Systemic manifestations: urolithiasis, interstitial nephritis, acute gouty nephropathy.
The approximate formulation of the diagnosis:
• Gout; acute arthritis, 1st attack.
• Gout: chronic arthritis of the right ankle, left elbow joints, exacerbation. Achilles bursitis. FN 1 tbsp. Urolithiasis, chronic interstitial nephritis, chronic renal failure 0 tbsp.
Psychological, social status are established according to general principles.
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Gout (code? 10)
Gout (P) - a disease caused by impaired purine metabolism; characterized by hyperuricemia, recurrent acute, and subsequently chronic arthritis, as well as kidney damage. The essence of the disease is a violation of uric acid metabolism, as a result of which crystals of monosodium urate are deposited in the joints and periarticular tissue, which leads to the development of arthritis. Besides
(Greek poclos — leg, agra — seizure, literally “leg in a trap”) has been known since ancient times, but its classical description is associated with the name of the English clinician of the 17th century T. Sidenamm. This is the third most common (after RA and DOA) arthropathy, which occurs both in acute (subacute) and in chronic form. Its frequency in Europe and the USA is 0.01-0.3% of cases of all diseases, and among diseases
Physical blockage Gout is a metabolic disorder characterized by an increase in the level of uric acid in the blood and the deposition of its salts in the joints and in the kidneys. This disease affects mainly men, and salts are most often deposited in the big toes, knees or feet. Emotional blocking If the big toe is affected, gout is a sign that a person
Cause metabolic disorders associated with errors in the diet (excess fat, protein, salt and meat dishes rich in purines). With an excess of purines in the blood, an excess of uric acid is formed, the kidneys can not cope with its withdrawal, and uric acid crystals are deposited in the joints. A large amount of alcohol also makes it difficult to remove uric acid from the body. Less commonly, gout becomes
- a chronic, progressive metabolic disease, manifested by an increased content of uric acid in the blood and the deposition of urate crystals in the tissues of the musculoskeletal system and internal organs. The main clinical manifestations In the gout clinic, the most typical is an acute attack of gouty arthritis, which is more often observed in men over 30 years of age.
- Pathology of purine metabolism. Gout
The main clinical syndrome caused by a disorder of purine metabolism is gout. Gout is understood to mean a heterogeneous group of disorders of purine metabolism, manifested by severe hyperuricemia, bouts of arthritis (usually mono-articular in nature), deposition of crystals of sodium urate monohydrate in tissues (gouty cones - tophi urici), uraturic nephropathy and
- Nutrition for exacerbation of gout
Treatment for an acute attack of gout includes bed rest, a strict diet, and medication. For the entire period of exacerbation exclude meat and fish products. Nutrition consists mainly of liquid foods (milk, dairy products, jelly, stewed fruit, vegetable and fruit juices, weak tea with milk or lemon, vegetable soups, liquid cereals). It is necessary to ensure that the patient does not
- 85. GAME. ETHIOLOGY, PATHOGENESIS, CLINIC, DIAGNOSTIC, TREATMENT PRINCIPLES.
Gout - refers to the pains of metabolic “errors” and microcrystalline arthropathy, is associated with almost constant hyperuricemia (in the urine test) and the uric acid microcrystals in the tissue of the joint, kidney, vascular wall, less often the heart, eyes. Etiology - distinguish between primary (hereditary) gout - a defect in enzyme systems; secondary - leukemia during their treatment with cytostatics,
- GHOST AND OTHER PURINE EXCHANGE VIOLATIONS
William N. Kelly, Thomas D. Palilla (William N. Kelley, Thomas D. Patella) The term "gout" refers to a group of diseases that, when fully developed, are manifested: 1) an increase in the level of urate in serum; 2) repeated attacks of characteristic acute arthritis, in which crystals of monosubstituted sodium urate can be detected in leukocytes from synovial fluid; 3)
- DEFORMING OSTEOARTHROSIS. GOUT.
DEFORMING OSTEOARTHROSIS (DOA). In 1911 in London at the International Congress of Physicians, all joint diseases were divided into two groups: primary inflammatory and primary degenerative. Rheumatoid arthritis and ankylosing spondylitis belong to the first group. The representative of the second group is DEFORMING OSTEOARTHROSIS (DOA), which is: degenerative-dystrophic disease
- NUTRITION FOOD
- Sample menu for a week with gout MONDAY
Fasting: broth of wild rose. First breakfast: tea with milk, cucumber salad with sour cream. Second breakfast: fruit juice. Lunch: rice soup with potatoes on a vegetable broth, fried cabbage cutlets, dried fruit compote. Snack: broth of wild rose. Dinner: scrambled eggs, carrot zrazy with prunes, tea with lemon. At night: kefir. TUESDAY Fasting: rosehip broth. First breakfast: tea with milk, salad with
- Treatment of joint pain, gout and pain in inflammation of the sciatic nerve
General reasoning. When it is known that the cause is simple nature, it is easy to treat, because it is often a simple inflammation, without a tumor, and it is enough to change the nature; most of all, yellow bile and blood must be removed. It also happens from hardening and cold, causing pain; then it is enough to change the nature, and most of all it is necessary to remove the mucus in order to warm the blood. Often
- Joint pain and what is common to gout, inflammation of the sciatic nerve and the like
The pernicious cause in these diseases is the receptive organ, and the current cause is the [state] of nature and bad juices. The reason associated with the tool is the width of the natural passages due to a random circumstance or addition, or the appearance of unnatural passages resulting from movements, as well as the rarity and porosity of tissues due to
- Pneumonia (code J 18)
Definition Pneumonia is an acute nonspecific infectious inflammatory process with damage to the lower respiratory tract, the diagnostic criterion of which is the syndrome of inflammatory infiltration of the lung tissue, verified by x-ray methods. Statistics. In outpatient practice, acute viral and bacterial respiratory tract infections account for 25% of all
- Pleurisy (code J 90)
Definition Pleurisy is a clinical and morphological syndrome characterized by inflammation of the pleura with the formation of fibrin on their surface (dry pleurisy) or the accumulation of fluid in the pleural cavity (exudative pleurisy). Statistics. According to R.U. Light (1996), for a population of about 370 million people in the United States, 1 million patients with pleural effusion are registered annually. Statistical development
- Thrombocytovasopathies (code D 69.1)
Definition A group of diseases associated with impaired platelet and, indirectly, vascular hemostasis, characterized by techno-ecchimatic and ecchymatic types of bleeding. Statistics. The second most common pathology of the blood system after iron deficiency anemia. The ratio of suffering men to women is approximately 3: 5. It is rare in early childhood, the first manifestations
- Vasopathies (code D 69.0)
Definition A group of diseases in which bleeding is caused by defects in the vascular wall. They are characterized by a petechial type of bleeding. Previously, diseases of this group were described under the general name "Shenlein-Genoch disease," but vasopathies are heterogeneous. The reasons leading to their development are various, the first place is occupied by chronic purulent infections. Most common disease
- Thyroiditis (code? 06)
Definition Combined group of diseases, which is based on the general pathological process - inflammation of the thyroid gland. Statistics. The disease is more common in people aged 30-50 years, the ratio of men and women is 1: 8, 1:10. Etiology. Pathogenesis. Pathological anatomy. In the etiology of acute and subacute non-purulent thyroiditis, the main place is occupied by viruses (adenoviruses, Coxsackie viruses, virus
- Hypothyroidism (code? 03)
Definition Hypothyroidism is a polyetiological disease that occurs with clinical and metabolic equivalents of thyroid hormone deficiency. Statistics. One of the common human diseases. Sick 0.2-1% of the population. Subclinical forms are found in 7-10% of women and 2-3% of men (Melnichenko G.A., 1998). Etiology. Pathogenesis. Congenital hypothyroidism (myxedema) due to