MODULE 6 KNOWLEDGE CHECK

5

Case Study Analysis

Nnenna Nwagbo

Review WU template for inclusion criteria for their cover page-Walden University

NURS 6501N-Advaced Pathophysiology

Dr. Thomas Sweeney

January 01/25/2021

Introduction

The assigned case scenario reflects a 58-year-old male who presents with a Patient's past medical history indicates that he had suffered (how does one determine suffered?) from included of hypertension and Type II 2 diabetes mellitus. However, the patient's The presenting symptoms, including fever, pain, chills, and swelling in the right great toe. A working diagnosis of Gouty Arthritis has been determined. , require him to undergo a diagnosis of gouty arthritis. The purpose of this paper will be to discuss…….Help me understand why it is this the 3rd time I am mentioning this?

Indent Gout is a common inflammatory arthropathy that leads to the accumulation of deposits of monosodium urate crystals in bone, joint, and soft tissue after a temporary occurrence of hyperuricemia. The deposition of crystals results in an innate inflammatory response (reference?) .

Neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

According to the patient's past medical history, the man had suffered from hypertension and Type II diabetes mellitus. However, the patient's symptoms, including fever, pain, chills, and swelling in the right great toe, require him to undergo a diagnosis of gouty arthritis this appears to be stated above.. Gout is a common inflammatory arthropathy that leads to the accumulation of deposits of monosodium urate crystals in bone, joint, and soft tissue after a temporary occurrence of hyperuricemia. The deposition of crystals results in an innate inflammatory response. This appears to be stated above.

The primary Ssymptoms of gouty arthritis are severe, abrupt pain, redness, and swelling, in the joints and the big toe, similar to the patient’s symptoms. Gouty arthritis results due to an inflammatory reaction that leads to the deposition of monosodium urate (MSU) crystals in a patient's joint with hyperuricemia This appears to be stated above.. The inflammation prompted by MSU is caused by constituents of the natural immune system, which are produced generally with the preliminary generic immune response and hinder its ability to attack pathogens (reference?).

The inflammatory mediators which act as the leading players for gouty arthritis encompass IL-1β, which controls differentiation, apoptosis, and cell proliferation. IL-1β is a type of proinflammatory cytokine which stimulates the manifestation of various inflammatory mediators. The mediators are unswervingly in control of neutrophil influx in individual synovium, a sign of gouty arthritis. After some time, the severe inflammation is usually accompanied by recurrent sparkles of gouty arthritis, causing a pathologic joint injury, resulting in something known as "tophi," a buildup of MSU deposits in the joints of the great toe and on the small phalangeal junctures. Also, uric acid's overproduction typically comprises neurological abnormalities, including cognitive dysfunction, articular manifestations dystonia, and neurotic injurious behavior. This pathogenesis describes the pathophysiologic processes that encompass the patient's musculoskeletal and neurologic systems as it has been portrayed in the symptoms he is experiencing (reference?) .

Hyperuricemia is referred as a high uric acid levels in the blood.

Pathogenesis of gouty arthritis: although nicely done and incorporated, not required. In so doing, this exceeds WU page limit for this assignment -5%

Racial/ethnic variables that may impact physiological functioning.

In regards to racial and ethnic variability, gouty arthritis is most common amongst black males than whites. In various genetic studies, the black populace-consider clarifying? have a genetic locus related to hyperuricemia. According to a particular study conducted to determine the influence of racial/ethnic variables, black males had an advanced gout burden (Ristic et al., 2019). Thus, there is a more significant comorbidities occurrence, including hypertension, obesity, and renal failure. Nonetheless, both women and men, irrespective of race, are at risk of developing gout arthritis. A cross-sectional study that involved countrywide descriptive data established that gout is 5.0% among the blacks and 4.0% amongst the whites (Parthasarathy & Vivekanandan, 2018). Also, the prospective study- who’s prospective study, I do not see a reference?) , which was not population-centered, demonstrated a 2-fold additional risk of gout in African Americans in male doctors than in their white counterparts; though, their variances in hypertension prominence caused the difference in jeopardy.

How these processes interact to affect the patient?

The usage of predisposing medicines such as diuretics and late diagnosis and treatment has a significant effect on gout arthritis pathophysiology (Yang et al., 2019). Therefore, regarding the patient in the scenario, the comorbidity of diabetes mellitus and hypertension and his taking up with diuretics (hydrochlorothiazide) could distress his gouty arthritis diagnosis.

Conclusion

Due to an increase in occurrence and high incidence of gout arthritis amongst women and men The paper indicated African Americans? and mostly those with a medical history of diabetes and hypotension or hypertension? , it is essential to enumerate the possibility of gout in both men and women from both white and black races. Although it is uncertain if the differences in gout arthritis occurrences are related with race? Your paper gives the impression that race is a factor? and if the differences are results to the disparity in gout risk aspects.

References

Parthasarathy, P., & Vivekanandan, S. (2018). A numerical modelling of an amperometric-enzymatic based uric acid biosensor for GOUT arthritis diseases. Informatics in Medicine Unlocked, 12, 143-147.

Ristic, B., Sikder, M. O. F., Bhutia, Y. D., & Ganapathy, V. (2019). Pharmacologic inducers of the uric acid exporter ABCG2 as potential drugs for treatment of gouty arthritis. Asian Journal of Pharmaceutical Sciences. Consider completing the reference. Upon cross checking the reference the following was noted: Asian J Pharm Sci . 2020 Mar;15(2):173-180. doi: 10.1016/j.ajps.2019.10.002.

Yang, T. H., Yan, D. X., Huang, X. Y., Hou, B., Ma, Y. B., Peng, H., ... & Geng, C. A. (2019). Termipaniculatones AF, chalcone-flavonone heterodimers from Terminthia paniculata, and their protective effects on hyperuricemia and acute gouty arthritis. Phytochemistry, 164, 228-235.