Tiêu đề SCA- MSK - Imtiyaz Medical_watermark (1).pdf ✅

SCA- MSK Dr.Amr Ibrahim MB ChB, MD, Alexandria University, Egypt MSc, University of Tsukuba, Japan
MUSCULOSKELETAL ▪ https://www.versusarthritis.org/about- arthritis/ ▪ In all cases => bring the pt for F2F examination if not examined yet.
Qs: If you have routine bloods showed uric acid of 600 , what to do next ? A- Give allopurinol B- Give NSAIDs C- It depends Offer urate-lowering therapy (ULT) using a treat-to-target strategy to people with gout who have: • Multiple or troublesome flares. • Chronic kidney disease (CKD) stages 3 to 5 (glomerular filtration rate [GFR] categories G3 to G5). • Diuretic therapy. • Tophi. • Chronic gouty arthritis. • Discuss ULT options with all other people experiencing a first or subsequent flare.
GOUT Qs To ask: ▪ What symptoms, if joint pain, which joint , for how long ? ▪ Any other symptoms => redness, swelling , hotness ▪ Ask about systemic symptoms => Fever , shivery, feels very unwell palpitations. ▪ Ask about renal stone symptoms (flank pain or abd pain, dysuria, haematuria) ▪ Any other joints affected? Any skin symptoms like rash? Any blurry vision or pain in the eyes ? ▪ Any nail changes. ▪ Any trauma ? ▪ Any skin lumps/swellings , any lumps in the ears? ▪ Any previous similar attacks? ▪ Any wt Loss, night sweats? ▪ If on any meds that could trigger gout => do you take the meds every day? E.g.: Diuretics (thiazide and loop), Ciclosoprin, Cytotoxic drugs. ▪ Detailed social hx – esp diet (red meat, sea food), alcohol (how much does he drink), work (Impact). ▪ FHx of gout ▪ ICE , impact on work or daily life – as he might need sick note