Term
| 1. How do you introduce a gout consultation? |
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Definition
| 1. "Hello, I'm Dr [Name]. Confirm your name/DOB? I understand you have toe pain - tell me more." |
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Term
| 2. What 7 key questions assess acute gout pain? |
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Definition
2.
- "Describe the pain"
- "When did it start?"
- "Sudden or gradual?"
- "Getting worse?"
- "Constant or intermittent?"
- "What aggravates it?"
- "Tried any treatments?" |
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Term
| 3. What 5 red flag questions rule out septic arthritis? |
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Definition
1. "Fever/chills?"
2. "Skin breaks/discharge?"
3. "Insect bites/injuries?"
4. "Rashes/other joint pain?"
5. "Feeling generally unwell?" |
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Term
| 4. What 5 risk factors for hyperuricaemia should be explored? |
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Definition
- Medical conditions (HTN)
- Medications (thiazides)
- Smoking/alcohol habits
- Obesity status
- Diet (red meat/shellfish/sugary drinks) |
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Term
| 5. How do you address ICE (Ideas, Concerns, Expectations)? |
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Definition
- Ideas: "Any thoughts what this might be?"
- Concerns: "Worried it's serious like cancer?"
- Expectations: "Hoping for pain relief/diagnosis?" |
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Term
| 6. What examination findings support gout diagnosis? |
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Definition
- Swollen, red, hot, tender 1st MTP joint
- No injury signs
- Normal systemic observations
- (Note: May use photo in OSCE) |
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Term
| 7. How do you explain gout to a concerned patient? |
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Definition
| "Inflammatory arthritis from uric acid crystals in joints. Causes sudden severe pain/swelling. Linked to your weight, alcohol, and BP medication. Treatable and reversible - not cancer." |
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Term
| 8. What 4 investigations are needed? |
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Definition
- Bloods: Uric acid, FBC, CRP, renal profile, HbA1c, lipids
- Foot X-ray (if concern for erosion/infection)
- Urine dipstick
- Stop thiazide diuretic immediately |
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Term
| 9. What 3 medication options treat acute flares? |
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Definition
9.
1. Naproxen 500mg BD + PPI (if no GI/Renal issues)
2. Colchicine 500mcg TDS x3 days
3. Prednisolone 30mg OD x5 days
(Choose based on comorbidities) |
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Term
| 10. What 4 lifestyle modifications are essential? |
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Definition
10.
1. Alcohol reduction (especially beer)
2. Weight loss referral
3. Purine-restricted diet (avoid red meat/shellfish)
4. Smoking cessation support |
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Term
| 11. What RICE measures apply to gout? |
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Definition
- Rest joint
- Ice application
- Compression (light)
- Elevation |
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Term
| 12. What safety netting advice is crucial? |
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Definition
12. "Return urgently if:
- Worsening pain
- Fever develops
- Swelling spreads
- No improvement in 48 hours" |
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Term
| 13. What 5 elements comprise follow-up planning? |
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Definition
13.
1. Review in 1-2 weeks post-flare
2. Recheck uric acid levels
3. Hypertension clinic referral (alternative meds)
4. Dietitian follow-up
5. Smoking cessation program |
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Term
| 14. When is allopurinol initiated? |
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Definition
14. If:
- Recurrent flares (>2/year)
- Joint damage on X-ray
- Persistent hyperuricaemia
- Patient preference
(Never start during acute flare) |
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