Beruflich Dokumente
Kultur Dokumente
by Juhairina
Gout
What is Gout?
• Hereditary
– Gout does run in families and is carried on through the genes.
• Fungi
– Fungi contaminate rich, fatty foods and alcohol. They are able to
manufacture uric acid in the bodies of people susceptible to fungal
infections.
• Metabolic illnesses
Causes of Gout
• Diet
– The consumption of proteins, especially meat, rich fatty foods and
alcohol promote uric acid production. Uric acid is a by-product of
protein metabolism in the liver. Gout results from the excess
production of uric acid.
• Stress
– Gout attacks are triggered by stress
• Weight
– Excess weight, high blood fat levels and diabetes increase the
incidence of gout
Symptoms of Gout
• Joint inflammation with acute pain, swelling,
redness and heat.
• An attack of gout can be severely painful and
occurs without warning.
• Main joints affected are the large toe most
often with inflammation.
• Pain in the knee, thumb, and elbow joints.
• May be accompanied by fever and fatigue.
• Alternating chills and fever.
Lab Findings
• The serum uric acid is elevated (> 7.5 mg/dL)
– However, a single uric acid determination is normal in
up to 25% of cases, so it does not exclude gout,
• ESR and white cell count are frequently elevated.
• Identification of sodium urate crystals in joint
fluid or material aspirated from a tophus
establishes the diagnosis.
– The crystals, which may be extracellular or found
within neutrophils, are needle-like and negatively
birefringent when examined by polarized light
microscopy.
Treatment
Treatment of Acute attacks
• The mainstay of treatment: Nonsteroidal anti-inflammatory
drugs (NSAIDs), colchicine, or glucocorticoids.
– In attacks involving one or two joints, intraarticular
glucocorticoid injections may be preferable and effective.
BMR
– 1x24x 63 = 1512 kcal
• Physical Activity: Light
– = 50% x 1512
– =756 kcal
• SDA
– =10% x(1512 +756)
– = 227kcal
• TER
– 1512+ 756+227
– =2495 kcal
• Percentage Distribution:
– 70% CHO
– 10% CHON
– 20% FAT
• CHO =2495x 70% = kcal /4 = 1747 g ~ 437 g
• CHON =2495x 10% = kcal /4 = 250 g ~63 g
• FAT = 2495x 20% = kcal / 9 = 499 g ~55 g
Diet Prescription
TER= 2495kcal, CHO= 437g, CHON= 63g,
FAT= 55g
Food Number of CHO CHON FAT ENERGY
exchanges
Vegetable A 1
Vegetable B 3 9 3 48
Fruit 6 60 240
Milk 2 24 16 20 40
Sugar 2 10 40
Rice 14 322 28 1400
Meat 2 16 4 100
Fat 6 30 270
Total 425 63 54 2098
Dividing a Day’s Exchange
Between Meals and Snacks
Food Breakfast Lunch PM Snack Dinner Midnight
Snack
Vegetable A 1
Vegetable B 1 1
Fruit 2 2 1
Milk 1 1
Sugar 1 1
Rice 4 4 4 2
Meat 2 2 2
Fat 2 2
Translating A Day’s Exchange into
A Day’s Meal
Meal time Food