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Dietary

Increase breakage of

Excess of Uric acid in blood

Overproduction of

Excreted through

Breakdown of purine
metabolism

Kidney disease
( Glumerulonephritis & Renal
Failure)
Decrease uric acid
secretion
( underexcretion )

CONCEPT MAP GOUT
hyperuricemia

uric acid hyepersaturated in blood plasma & precipitation of
urate in body fluid

Formation of monosodium urate ( crystal
shedding )

(+)
urate

Covered by
protein (IgG)

Alcoh
ol

Accumulation and
precipitation MSU

uric acid stones
formation
Proteinuria,
hypertension,
Obstruct
the
acidic and
Elevat
excretion
of uric
CBC
concentrated
ed
WBC ,
ESR
(+)

Phagocytosis by

Fusing of vacuolar and lysosomal
membrane

Forming gouty tophi at
cartilage of car, oleurenon
bursa, etc
Increase inflammation
Swollen, redness,
pseudogot
Increase enlarging
and protruding of
NI
3
joints
fever
Fluid electrolyte
imbalance
NI 3

Increase lactic
acid as waste
product of

Stimulates neutrophil, leukocytes,
monocyte, fibroblast, synoviacyte, renal
cells.

In Particular connective
tissue, joints and articular
cartilage

kidney

Urine
collectio
n 24
Hours

Fluid
joint
aspirat
e

Increase Tissue
damage
Joints Stiffness or
NI 2constriction

Hydrogen bonding between crystal surface
and lysosomal membrane

Meds :
Rupture of phagolysosomal and
disruptionNSAIDs,
of leukocytes

Impaired
physical of joint
Deformities
mobility
numbne
contracture
Self body
Acute
ss image
NI 1
NI
2
NI
1
pain
rigid
Pain / acute pain
chronic
swollenFibrous

Analgesic,
MRI
colchicine
Ultrasoun
d X-Ray