Gout
Patient complains of severe joint pain
Joint/s affected:
Patient states they have a history of gout and this feels like that
On Examination:
The patient is afebrile
Joint affected feel hot and very sensitive to movement
Clinical Impression: Gout
Plan:
1. Anti-inflammatory medication prescribed (indomethicin, Colchicine or Prednisone)
2. Apply hot compresses or ice to the joint involved
3. Bed Rest
Discussed the usefulness of Allopurinol. Not prescribed at this time but if continued attacks the patient will represent for treatment
Discussed the "Rules of Moderation" and these notes have been printed and provided to the patient
Rules of moderation
Do:
• restrict intake of food high in purines, especially organ meats (liver, brain, kidneys, sweetbread), shellfish and tinned fish (sardines, anchovies, herrings), game, pork
• reduce your intake of alcohol, especially beer and red wine
• reduce or cease intake of sugary, fizzy soft drinks and fruit juices that contain fructose
• eat a normal, well-balanced diet
• drink plenty of water—at least 2 litres a day
• maintain a normal weight, but avoid ‘crash’ diets
• wear comfortable shoes
• get regular exercise.
Don’t:
• take your worries to bed
• exercise too strenuously
• overexpose yourself to cold
• drink excessive amounts of alcohol (keep to a modestlevel only, e.g. 2 standard drinks a day maximum)
• drink fizzy, sugary soft drinks and fruit juices withfructose.
Joint/s affected:
Patient states they have a history of gout and this feels like that
On Examination:
The patient is afebrile
Joint affected feel hot and very sensitive to movement
Clinical Impression: Gout
Plan:
1. Anti-inflammatory medication prescribed (indomethicin, Colchicine or Prednisone)
2. Apply hot compresses or ice to the joint involved
3. Bed Rest
Discussed the usefulness of Allopurinol. Not prescribed at this time but if continued attacks the patient will represent for treatment
Discussed the "Rules of Moderation" and these notes have been printed and provided to the patient
Rules of moderation
Do:
• restrict intake of food high in purines, especially organ meats (liver, brain, kidneys, sweetbread), shellfish and tinned fish (sardines, anchovies, herrings), game, pork
• reduce your intake of alcohol, especially beer and red wine
• reduce or cease intake of sugary, fizzy soft drinks and fruit juices that contain fructose
• eat a normal, well-balanced diet
• drink plenty of water—at least 2 litres a day
• maintain a normal weight, but avoid ‘crash’ diets
• wear comfortable shoes
• get regular exercise.
Don’t:
• take your worries to bed
• exercise too strenuously
• overexpose yourself to cold
• drink excessive amounts of alcohol (keep to a modestlevel only, e.g. 2 standard drinks a day maximum)
• drink fizzy, sugary soft drinks and fruit juices withfructose.
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