September 16, 2023

1400H - 1500H
Via Zoom

Empowerment
objective - for
laypeople to have an
GOUT essential
ARTHRITIS understanding of
GOUT ARTHRITIS in
their health
management.
 September 16, 2023
1400H - 1500H
Via Zoom
Welcome all!

MUTE yourself but always

Empowerment show your video picture.

objective - for Sign in your name, FB

laypeople to have an account, or email address in
the Chat Box! Include names
GOUT essential of companions attending.
ARTHRITIS understanding of Use the Chat Box to ask
GOUT ARTHRITIS in questions and make
comments while the PEP TALK
their health is on.
management.
There will be group pictures
at start and end of PEP TALK –
show your face in video.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment FEEDBACK TO THIS
objective - for PEP TALK!
laypeople to have an
GOUT essential Pls. type in your
ARTHRITIS understanding of feedback in the chat
GOUT ARTHRITIS in box during the open
forum and before we
their health adjourn!
management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
objective - for START PEP TALK
PROPER IN 2
laypeople to have an MINUTES!
GOUT essential
ARTHRITIS understanding of Pls. turn on your
GOUT ARTHRITIS in video!
their health Show your face!
management.
 ROJoson PEP Talk
Empowerment
objective - for I have a Patient
laypeople to have an Empowerment
GOUT essential Program in which I
ARTHRITIS understanding of like to empower the
GOUT ARTHRITIS in lay people or
patients to take
their health
control in the
management. management of
their health.
I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.
 My PEP TALK today is
entitled:

Empowerment GOUT ARTHRITIS

objective - for
laypeople to have an
GOUT essential
ARTHRITIS understanding of
GOUT ARTHRITIS in
their health
management.
 Contents Disclaimer:
• What is a GOUT? What is a GOUT ARTHRITIS?
• What is the cause of GOUT ARTHRITIS? ROJoson PEP Talk
GOUT • What is hyperuricemia? What are the causes?
contains ROJoson’s
ARTHRITIS • What are the side effects of hyperuricemia?
Thoughts,
• What are the risk factors for GOUT ARTHRITIS?
• What are the modifiable causes of hyperuricemia that Perceptions,
one can avoid to prevent GOUT ARTHRITIS? Opinions and
• What joints are usually affected by GOUT ARTHRITIS? Recommendations
• What are the phases / stages of GOUT ARTHRITIS?
• When to suspect GOUT ARTHRITIS? How to
(TPORs) culled from
differentiate from other ARTHRITIS? experiences of other
• What is the management of GOUT ARTHRITIS? professionals and
• Is there a cure for arthritis (gout, osteo, rheumatoid)? ROJoson.
 What is a GOUT? What is a GOUT ARTHRITIS?

GOUT GOUT is a form of ARTHRITIS.

GOUT ARTHRITIS is an ARTHRITIS caused by
ARTHRITIS deposition of uric crystals on the joint.
GOUT = GOUT ARTHRITIS

ARTHRITIS is inflammation of a joint or several

joints.

Note: Not all ARTHRITIS are due to GOUT. There

are other causes of ARTHRITIS such as
osteoarthritis and rheumatoid arthritis.
 What is the cause of GOUT
ARTHRITIS?
GOUT
GOUT ARTHRITIS is caused by
ARTHRITIS too much uric acid in the
blood (hyperuricemia) that
leads to deposition of uric
crystals in a joint or several
joints causing inflammation.
 What is hyperuricemia? What are the causes?

GOUT Hyperuricemia occurs when uric acid levels in the blood are too high.
ARTHRITIS Uric acid is produced when the body breaks down a chemical called
purine.

Purine occurs naturally in your body, but it's also found in certain foods.

Uric acid is eliminated from the body in the urine.

If the kidneys are unable to clear out uric acid fast enough, there will be
hyperuricemia.
 What is hyperuricemia? What are the causes?

GOUT Hyperuricemia occurs when uric acid levels in

the blood are too high.
ARTHRITIS
This elevated level is the result of
• increased production
• decreased excretion of uric acid
• or a combination of both processes
 What is hyperuricemia? What are the causes?

GOUT URATE OVERPRODUCTION

• PURINE RICH DIET
ARTHRITIS • AN ERROR OF PURINE METABOLISM: hypoxanthine
phosphoribosyltransferase (HPRT) deficiency,
phosphoribosylpyrophosphate (PRPP) synthetase over
activity
• CELL BREAKDOWN OR TURNOVER: lymphoproliferative
diseases, myeloproliferative disease, polycythemia vera,
Paget disease, psoriasis, tumor lysis, hemolysis,
rhabdomyolysis, EXERCISE
 What is hyperuricemia? What are the causes?

GOUT DECREASED URIC ACID EXCRETION

ARTHRITIS ACUTE OR CHRONIC KIDNEY DISEASE, acidosis
(lactic acidosis, ketoacidosis), hypovolemia,
MEDICATION/TOXIN (DIURETIC, NIACIN,
PYRAZINAMIDE, ETHAMBUTOL, CYCLOSPORIN,
BERYLLIUM, SALICYLATES, LEAD, ALCOHOL),
sarcoidosis, hyperparathyroidism,
hypothyroidism, Bartter syndrome, Down
syndrome
 What are the side effects of hyperuricemia?

GOUT High uric acid levels in the bloodstream or

hyperuricemia can cause
ARTHRITIS
• GOUT ARTHRITIS
• KIDNEY STONES
 What are the risk factors for GOUT ARTHRITIS?

• More common in MEN than in WOMEN.

GOUT
• WOMEN are more likely to get it
ARTHRITIS after menopause.
• Overweight
• Alcohol
• Family history of gout
• Maintenance medicines such as diuretics (water
pills) that help with high blood pressure
• Metabolic syndrome such as high blood
pressure, high cholesterol, diabetes, or heart
disease
 What are the modifiable causes of hyperuricemia
that one can avoid to prevent GOUT ARTHRITIS?
GOUT
• Overweight and obesity
ARTHRITIS • Increase in consumption of
• sugar-sweetened beverages
• foods rich in purines
• Alcohol
 What joints are usually
affected by GOUT ARTHRITIS?
GOUT
Usually, big toe
ARTHRITIS
but may affect other joints like
ankle, knee, hand, wrist, and
elbow
 00:00

What are the phases / stages of GOUT

ARTHRITIS?
GOUT
Gout progresses through four clinical phases:
ARTHRITIS
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
Majority of people have asymptomatic
hyperuricemia because of excessive purine-rich
food intake.
 00:00

What are the phases / stages of GOUT

ARTHRITIS?
GOUT
Gout progresses through four clinical phases:
ARTHRITIS
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
 00:00

What are the phases / stages of GOUT

ARTHRITIS?
GOUT
Gout progresses through four clinical phases:
ARTHRITIS
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout

TOPHI
 00:00

What are the phases / stages of GOUT

ARTHRITIS?
GOUT
Gout progresses through four clinical phases:
ARTHRITIS
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout

TOPHI
 00:00

When to suspect GOUT ARTHRITIS?

GOUT Doctors usually diagnose gout based on your

symptoms and the appearance of the affected
ARTHRITIS joint.

Other confirmatory diagnostic tests may be

needed.
 How to recognize and diagnose GOUT?

GOUT Typical symptoms of GOUT ARTHRITIS (in acute

attack):
ARTHRITIS
Sudden attacks of severe pain, often with
redness and swelling around the joint, most
commonly in the big toe.
 00:00

When to suspect GOUT ARTHRITIS?

GOUT NOT all joint pains with swelling and

inflammation are GOUT ARTHRITIS.
ARTHRITIS
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
 00:00

When to suspect GOUT ARTHRITIS?

GOUT NOT all joint pain, swelling and inflammation are

GOUT ARTHRITIS.
ARTHRITIS
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
 00:00

When to suspect GOUT ARTHRITIS?

GOUT NOT all joint pain, swelling and inflammation are

GOUT ARTHRITIS.
ARTHRITIS
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
 00:00

When to suspect GOUT ARTHRITIS? How to differentiate from other

ARTHRITIS?
GOUT
GOUT – usually big toes (with acute inflammation) and with GOUT
ARTHRITIS FLARES.
Presence of TOPHI (chalk-like substance).

OSTEOARTHRITIS – usually with pain but not as intense and gradual as

GOUT; morning stiffness and disappearing after movement; pain on
movement; asymmetrical joint involvement.

RHEUMATOID ARTHRITIS – symmetrical joint involvement (bilateral)

 00:00

When to suspect GOUT ARTHRITIS? How to differentiate from

other ARTHRITIS?
GOUT
GOUT – usually big toes (with acute inflammation) and with
ARTHRITIS GOUT FLARES.
Presence of TOPHI.

OSTEOARTHRITIS – usually with pain but not as intense and

gradual; morning stiffness and disappearing after movement;
pain on movement; asymmetrical joint involvement.

RHEUMATOID ARTHRITIS – symmetrical joint involvement

(bilateral)
 00:00

When to suspect GOUT ARTHRITIS?

GOUT Confirmatory tests:

• Joint fluid test to look for urate crystals.
ARTHRITIS • Blood test to measure the levels of uric acid in
your blood (Blood test results can be
misleading, though. Some people have high
uric acid levels, but never experience gout.)
• X-ray imaging to rule out other causes of joint
inflammation.
• Ultrasound to detect urate crystals in joints or
in tophi.
 00:00

What is the management of GOUT ARTHRITIS?

• Acute attacks – pain medications (NSAIDs –

GOUT
Nonsteroidal anti-inflammatory drugs)
ARTHRITIS • Intercritical period – medications to lower uric
acid in blood (with implementation of
strategies against modifiable factors of gout)
• Chronic gout with tophi formation – watch
and wait (with uric acid reduction measure) or
surgery if needed.
 00:00

What is the management of GOUT ARTHRITIS?

GOUT Prescription Medicines

• NSAIDs (Non-steroidal Anti-inflammatory
ARTHRITIS Drugs) reduces pain and inflammation.
• Allopurinol reduces uric acid production.
• Febuxostat reduces uric acid production.
• Colchicine reduces inflammation.
 00:00

What is the management of GOUT ARTHRITIS?

GOUT Surgery may at times be done for chronic gout

with tophi.
ARTHRITIS
 00:00

What is the management of GOUT ARTHRITIS?

Foods to Avoid
GOUT
Stay away from these types of food:
ARTHRITIS
•Beer and grain liquors (like vodka and whiskey)
•Red meat, lamb, and pork
•Organ meats, such as liver, kidneys, and glandular meats like the thymus
or pancreas
•Seafood, especially shellfish like shrimp, lobster, mussels, anchovies, and
sardines
•High-fructose products like soda and some juices, cereal, ice cream,
candy, and fast food
 00:00

What is the management of GOUT ARTHRITIS?

GOUT Best Foods for a Gout Diet (low-purine diet

options):
ARTHRITIS •Low-fat and nondairy- fat products, such as
yogurt and skim milk
•Fresh fruits and vegetables
•Nuts, peanut butter, and grains
•Potatoes, rice, bread, and pasta
•Eggs (in moderation)
•Meats like fish, chicken, and red meat are fine
in moderation
 00:00

What is the management of GOUT ARTHRITIS?

GOUT Drinks in GOUT

ARTHRITIS Do’s
• Drink lots of fluids -- 8 to 16 cups a day. At least half should be water.

Don’ts
• Stay away from sugary drinks like soda and fruit juice.
• Limit or avoid alcohol.
 Is there a cure for arthritis (gout, osteo,
rheumatoid)?
GOUT
There is no cure for arthritis.
ARTHRITIS
The treatment goal is to limit pain and
inflammation and preserve joint function.

Treatment options include exercise, weight

reduction, eat-in moderation especially purine-
rich foods, medicines and surgery if needed.
 Be always in touch with reliable medical Take Away in
information on GOUT ARTHRITIS. relation to
GOUT Patient
ARTHRITIS Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on GOUT ARTHRITIS
in your health management.
 Contents Disclaimer:
• What is a GOUT? What is a GOUT ARTHRITIS?
• What is the cause of GOUT ARTHRITIS? ROJoson PEP Talk
GOUT • What is hyperuricemia? What are the causes?
contains ROJoson’s
ARTHRITIS • What are the side effects of hyperuricemia?
Thoughts,
• What are the risk factors for GOUT ARTHRITIS?
• What are the modifiable causes of hyperuricemia that Perceptions,
one can avoid to prevent GOUT ARTHRITIS? Opinions and
• What joints are usually affected by GOUT ARTHRITIS? Recommendations
• What are the phases / stages of GOUT ARTHRITIS?
• When to suspect GOUT ARTHRITIS? How to
(TPORs) culled from
differentiate from other ARTHRITIS? experiences of other
• What is the management of GOUT ARTHRITIS? professionals and
• Is there a cure for arthritis (gout, osteo, rheumatoid)? ROJoson.
 Empowerment
objective - for
laypeople to have an
GOUT essential
ARTHRITIS understanding of
GOUT ARTHRITIS in
their health
management.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment FEEDBACK TO THIS
objective - for PEP TALK!
laypeople to have an
GOUT essential Pls. type in your
ARTHRITIS understanding of feedback in the chat
GOUT ARTHRITIS in box during the open
forum and before we
their health adjourn!
management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
objective - for START Q&A AND
INTERACTIONS!
laypeople to have an
GOUT essential Pls. turn on your
ARTHRITIS understanding of video!
GOUT ARTHRITIS in Show your face!
their health
management.