NURS 6501 / NURS6501: Advanced Pathophysiology - Module 5 Knowledge Check (Latest 2021 / 2022) Walden University

NURS 6501 - Advanced Pathophysiology Review Test Submission: Module 5 Knowledge Check Student Response This Knowledge Check reviews the topics in Module 5 and is formative in nature. It is worth 20 points where each question is worth 1 point. You are required to submit a sufficient response of at least 2-4 sentences in length for each question. Scenario 1: Gout A 52-year-old obese Caucasian male presents to the clinic with a 2-day history of fever, chills, and right great toe pain that has gotten worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief. Past medical history positive or hypertension treated with hydrochlorothiazide and kidney stones. Social history negative for tobacco use but admits to drinking "a fair amount of red wine" every week. General appearance: Ill appearing male who sits with his right foot elevated. Physical exam remarkable for a temp of 101.2, pulse 108, respirations 18 and BP 160/88. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 14,000 mm3 and uric acid 8.9 mg/dl. The APRN diagnoses the patient with acute gout. 1 of 2 Questions: Describe the pathophysiology of gout? Gout is an inflammatory condition caused by excessive uric acid production in the blood and other body fluids like a synovial fluid. Its pathophysiology is closely related to purine metabolism and kidney function. Uric acid is a breakdown product of purine nucleotides synthesized by purines at the cellular level that assist in synthesizing nucleic acids, adenosine triphosphate, and cyclic adenosine monophosphate, and cyclic guanosine monophosphate. Elevated uric acid (hyperuricemia) results in the formation of monosodium urate (MSU) crystals in and around joints; with a uric acid higher concentration greater than 6.8mg/dl, it starts to crystallize and form insoluble precipitates of MSU that deposited in connective tissues. MSU crystals triggers the acute inflammatory response that activates cytokines and interleukins, which attract neutrophils out of the circulation and starts phagocytizing the crystals.Causing acute painful inflammation of the joint.