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Related Concept Videos

Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

315
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
315
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

413
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
413
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

484
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
484
Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

492
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Related Experiment Video

Updated: Mar 23, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

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Published on: July 11, 2013

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[Gout management: an update].

Barbara Ankli1,2, Stephan Krähenbühl3

  • 11 Klinik für Rheumatologie, Universitätsspital Basel.

Therapeutische Umschau. Revue Therapeutique
|March 24, 2016
PubMed
Summary

Gout management requires treating flares and lowering urate levels (< 360 µmol/l). Guidelines emphasize proactive urate-lowering treatment (ULT) and flare prophylaxis, especially in patients with comorbidities like kidney disease.

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Area of Science:

  • Rheumatology
  • Internal Medicine
  • Pharmacology

Context:

  • Gout is the most prevalent global arthritis, yet many patients remain undertreated.
  • Current international guidelines (ACR, EULAR, 3e) advocate a 'treat-to-target' strategy for gout management.
  • This strategy involves managing acute flares, initiating urate-lowering treatment (ULT), and implementing flare prophylaxis.

Purpose:

  • To summarize current gout treatment guidelines and strategies.
  • To highlight the evolution of treatment indications and approaches over time.
  • To discuss challenges in gout management, including patient compliance and physician adherence to guidelines.

Summary:

  • Guidelines recommend ULT for most gout patients, with mandatory flare prophylaxis during initiation.
  • Colchicine is the preferred flare treatment, with NSAIDs and prednisone as alternatives; IL-1 blockers are an option for severe cases.
  • Xanthine oxidase inhibitors (XOIs) like allopurinol and febuxostat are primary ULTs, with uricosurics as a secondary option for patients with adequate renal function.
  • Challenges include managing patients with comorbidities (especially kidney disease), poor compliance, and low physician adherence to guidelines.
  • Therapeutic failure can lead to chronic, refractory gout, necessitating specialist rheumatologist involvement for complex cases.

Impact:

  • Improved understanding of evolving gout treatment paradigms.
  • Highlights the critical need for patient education to enhance compliance.
  • Emphasizes the importance of physician adherence to guidelines for optimal patient outcomes.
  • Identifies specific challenges in treating gout patients with comorbidities, particularly severe kidney disease.
  • Underscores the role of rheumatologists in managing complex and refractory gout cases.