PRACTICUM MATERIAL 10: GOUT CASES Description of Theory Gout is a progressive disease caused by the deposition of monosodium urate (MSU) crystals in the joints, kidneys, and other connective tissues as a result of chronic hyperuricemia. Without effective treatment, this condition can develop into chronic gout, the formation of tophus, and can even result in severe kidney function disorders. , as well as a decrease in quality of life. The underlying metabolic disorder of gout ishyperuricemia. For determination of gout risk, hyperuricemia is defined statistically as a serum urate concentration more than two standard deviations above the usual population mean of 7 mg/dL (416 umol/L for men and 6 mg/dL (357 umol/L) for women). is the final product of purine degradation which originates from the body or diet and is considered waste that must be removed. Excessive uric acid levels are a result of excess purine production or due to decreased elimination by the kidneys. In general, gout begins with acute inflammatory monoarthritis. Often the first joint to become inflamed is the metatarsophalangeal joint, but it can occur in other joints in the lower extremities as well and sometimes also in the wrist or fingers. The gout spectrum also includes nephrolithiasis, gouty nephropathy, and tophi in cartilage, tendons, synovial membranes, and elsewhere. Clinical symptoms of gout are fever, severe pain, erythema, warmth, swelling, and inflammation of the involved joints. Laboratory examination results showed an increase in serum uric acid and leukocytosis.Management of hyperuricemia without clinical symptoms can be done with lifestyle modifications, including diet patterns as per the general principles of management of hyperuricemia and gout. Implementation of CASE Practicum A 52 year old man, E. N, came to the hospital emergency room with complaints of pain in his right elbow. The patient said that yesterday he played basketball with his friend and when he woke up in the morning his right elbow was sore and stiff. The patient then took paracetamol, but after several hours the patient felt severe pain in his right elbow and found it difficult to move. Patient medical history:hypertension, mild gastritis, and obesity Treatment history: Captopril 25 mg twice a day History of allergies: There isn't any Vital sign examination results: blood pressure 120/90 mmHg, temperature 37oC, HR: 90x/minute, RR 16x/minute Results of physical examination of the right elbow: tenderness (+), right elbow is swollen, feels warm and reddish. ScoreVisual Analogue Scale (VAS):6 Laboratory examination results: Therapy : Piroxicam 10 mg No. XIV s. 2 dd 1 tab Allopurinol 100 mg No. XIV s. 1 dd 1 tab