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  • Case Report of Gout Arthritis

    Caricato da

    Muhammad Ikhlas Yasin
    9 visualizzazioni27 pagine
    presented as an internship at lasinrang hospital, pinrang

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    case report of Gout Arthritis

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    presented as an internship at lasinrang hospital, pinrang

    Copyright:

    © All Rights Reserved
    Scarica in formato PPTX, PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    9 visualizzazioni27 pagine

    Case Report of Gout Arthritis

    Caricato da

    Muhammad Ikhlas Yasin
    presented as an internship at lasinrang hospital, pinrang

    Copyright:

    © All Rights Reserved
    Scarica in formato PPTX, PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    di 27

    A CASE REPORT OF

    GOUT ARTHRITIS
    PRESENTED BY
    Dr. M. Ikhlas Yakin
    Lasinrang Hospital, Pinrang, Indonesia
    PATIENT IDENTITY
    Mr. K

    12 8 - 71 (46 Y.O)

    MR 072***

    Office Worker

    Date of examination ; 22 - 9
    -2017
    ANAMNESIS

    Symptom; Patient
    Pain in the Unable experien History History of
    dorsal part to walk ced the History
    of of eating HT &
    of the right because same organ
    foot,
    of the hiperuric trauma parts food DM (-)
    suddenly problem emia (+)
    after pain from last (-) (+)
    waking up month
    PHYSICAL EXAMINATION
    General Condition :
    Moderate pain (VAS 6-7)/ Well
    nourished/compos mentis

    Vital Sign
    Blood Pressure : 130/90mmHg
    Pulse : 92 bpm
    Respiration : 20 x/min
    Temperature : 36,5oC
    General Examination
    HEAD
    Conjungtiva ; anemic (-) Sclera ; icteric (-)
    Nose ; Oedema of the concha (-) , Ear ; Otorrhea (-) Tophy (-) , Lips ;
    Cyanotic(-)

    THORAX COR
    Inspection ; Symmetrical, Breathing movement (+) Inspection ; ictus cordis (-)
    Palpation; Pain (-) , Mass (-), Crepitation (-) Palpation ; ictus cordis (-)
    Percussion ; Sonor Percussion ; Dull
    Auscultation; Vesiculer, Ronkhi(-) Wheezing (-) Auscultation ; HS1&2 reguler

    ABDOMEN
    Inspection : flat
    Auscultation : peristaltic (+)
    Percussion : tympani
    Palpation : pain (-), hepar/lien not palpable

    EXTREMITY
    Limb : warm, parese (-), hipestesia (-), strict movement
    because of the pain, hiperemis (-)
    Oedema : (+) , pitting oedem (-)
    LOCAL SIGN
    REGIO PEDIS DEXTRA

    Hiperemis
    PAIN (+)
    (-)

    Oedem
    Tophy (-)
    (+)
    LABORATORIUM
    Test Result Normal Limit
    CHOLESTEROL 194 mg/dl 120-200 mg/dl
    URIC ACID 10,0 mg/dl (3,4-7,0 mg/dL)
    RESUME

    ANAMNESIS PE LAB

    DIAGNOSI
    S
    GOUT ARTHRITIS
    Inpatient Treatment
    ER 24 9 -2017
    22 9 2017 P : IVFD RL 20 dpm
    P : IVFD RL 20 dpm Inj. Fendex amp 50mg/8 hours/drips
    Santagesik amp 1gr/8 hours/iv Inj. Omeprazole vial 40mg / 12
    Neurobion 1000 amp 3ml/24 jam/im hours/iv
    Argout 0,5 mg tab 3x1
    Ward Alprazolam 0,5 mg tab 1x1
    23 9 -2017
    P : IVFD RL 20 dpm 24 9 -2017
    Inj. Fendex amp 50mg/8 hours/drips P : IVFD RL 20 dpm
    Inj. Omeprazole vial 40mg / 12 Inj. Fendex amp 50mg/8 hours/drips
    hours/iv Inj. Omeprazole vial 40mg / 12
    Argout 0,5 mg tab 3x1 hours/iv
    Alprazolam 0,5 mg tab 1x1 Argout 0,5 mg tab 3x1
    Alprazolam 0,5 mg tab 1x1
    DISCUSSION

    GOUT
    ARTH
    RITIS
    GOUT ?

    Group of signs and symptomps

    Deposition of crystal MSU

    Hiperuricemia

    Arthritis

    1. Rosani, Selti. Arthritis Gout, p.833-835 in Kapita selekta FKUI.Aesculapius.Jakarta.2014


    RISK FACTOR
    PATHOPHYSIOLOGY

    EXCESSIVE
    PRODUCTION OF
    URIC ACID

    DECREASING OF THE
    EXCRETION IN THE
    KIDNEY
    STADIUM
    DIAGNOSTIC
    SIGN SYMPTOM - PREDILECTION
    ADDITIONAL EXAM
    MANAGEMENT
    Colchicine (argout) acute
    dosage;
    1mg bolus, 0,5mg / 1 hour, 12
    hours later 0,5mg, max. 3
    mg/day
    Prophylaxis ; 0,5 mg / day
    MANAGEMENT
    URIC LOWERING THERAPY

    Tablet forms 100mg & 300mg Tablet forms 500 mg


    Initial dose 100 mg/ day (CKD 50 Initial dosage 0,5 gr/day may
    mg) increased until 2 gr/day
    Adjust dosage after 2-5 weeks (examine GFR before treatment)

    Target <6,0
    Slowly untill <5,0
    Life Style Modification
    AVOID AWARE SAFE
    Differential Diagnosis
    Differential Diagnosis

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