Gout - be given in high doses initially for at least two...

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Gout Diagnosis Gout may be diagnosed and treated without further investigations in someone with Hyperuricemia and the classic symptoms. Synovial fluid analysis should be done to rule out other causes such as septic arthritis and Pseudogout. Under the microscope monosodium urate crystals give a diagnosis of gout. Fluid from a joint must be examined quickly after aspiration, as temperature and pH affect their solubility. Blood tests can also be performed to detect hyperuricemia. Hyperuricemia is defined as a plasma urate level greater than 420 mol/L (7.0 mg/dL) in men and 360 mol/L (6.0 mg/dL) in women. Other blood tests may be able to detect the underlying causes such as renal failure and metabolic syndrome. X-rays will reveal changes associated with chronic gout however X-rays play little role in diagnosis. Treatment In an acute attack, NSAIDs are very effective at dissolving away the intra-articular crystals. They should
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Unformatted text preview: be given in high doses initially for at least two weeks. Whilst indomethacin has historically been the most commonly used NSAID, an alternative, such as ibuprofen, may be preferred due to its better side effect profile in the absence of superior effectiveness. For individuals who are unable to take NSAIDs, i.e. those with renal failure or peptic ulcers, they may be co-prescribed a Proton Pump Inhibitor or Colchicine. Colchicine is an alternative for those unable to tolerate NSAIDs. Colchicine is a toxic natural product and secondary metabolite, originally extracted from plants. Its side effects (primarily gastrointestinal upset) limit its usage. Gastrointestinal upset, however, depends on the dose, and the risk can be decreased by using smaller yet still effective doses....
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