For prevention of gout attacks serum urate lowering medications should be

For prevention of gout attacks serum urate lowering

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For prevention of gout attacks, serum urate-lowering medications should be reserved for patients who have a history of gout and any one of the following: at least two flares per year (one in patients with chronic kidney disease stage 2), tophi, or a history of nephrolithiasis (Hainer et. al, 2014). Allopurinol and Uloric are first-line treatment drugs for prevention of gout. References Hainer, Barry, Matheson, Eric, & Wilkes, Travis. (2014). Diagnosis, Treatment, and Prevention of Gout. American Family Physician, 15(90), 831-836. Retrieved from
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Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Mayo Clinic. (n.d.). Gout. Retrieved from - conditions/gout/diagnosis-treatment/drc-20372903 Qaseem A, Harris RP, & Forciea MA. (2017). Management of acute and recurrent gout: A clinical practice guideline from the American college of physicians. Annals of Internal Medicine. Retrieved from - recurrent-gout-clinical-practice-guideline-from-american-college Ragab, G., Elshahaly, M., & Bardin, T. (2017). Gout: An old disease in new perspective - A review. Journal of advanced research , 8 (5), 495-511. Retrieved from
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Hi Eulah You did an excellent job describing thyroid disorders and treatments. Thyroid Disorders Disorders of thyroid function develop as a result of primary dysfunction or disease of the thyroid gland or, secondarily, as a result of pituitary or hypothalamic alterations (Huether & McCance, 2017). Clinically, measurement of serum TSH and free T4 are used most commonly to assess thyroid function (Arcangelo et. al., 2017). I find hypothyroidism particularly interesting because it is the most common disorder of thyroid dysfunction, affecting between 1 and 2% of the population and it occurs more in women (Huether & McCance, 2017). According to Huether & McCance (2017), primary hypothyroidism accounts for 99% of all cases hypothyroidism and autoimmune thyroiditis (Hashimoto’s Thyroiditis) is the most common cause of primary hypothyroidism in the United States. Hashimoto’s thyroiditis occurs most commonly in middle- aged women (American Thyroid Association, n.d.). The condition tends to progress slowly over many years and individuals may not have symptoms early in the disease. Over time, thyroiditis can cause chronic cell damage to the thyroid causing a goiter. Patients will eventually develop symptoms of hypothyroidism including weight gain, fatigue, constipation, sensitivity to cold, dry skin, muscle aches, exercise intolerance, and irregular or heavy menses. Some individuals may have a strong family history leading to an earlier diagnosis. Lab screenings may pick up on elevated TSH with normal levels of thyroid hormone. These patients will have positive TPO antibodies.
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