1. GOUT
ARTHRITIS
September 16, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.

2. GOUT
ARTHRITIS
September 16, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

9. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.

10. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
My PEP TALK today is
entitled:
GOUT ARTHRITIS

11. Contents
• What is a GOUT? What is a GOUT ARTHRITIS?
• What is the cause of GOUT ARTHRITIS?
• What is hyperuricemia? What are the causes?
• What are the side effects of hyperuricemia?
• What are the risk factors for GOUT ARTHRITIS?
• What are the modifiable causes of hyperuricemia that
one can avoid to prevent GOUT ARTHRITIS?
• What joints are usually affected by GOUT ARTHRITIS?
• What are the phases / stages of GOUT ARTHRITIS?
• When to suspect GOUT ARTHRITIS? How to
differentiate from other ARTHRITIS?
• What is the management of GOUT ARTHRITIS?
• Is there a cure for arthritis (gout, osteo, rheumatoid)?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of other
professionals and
ROJoson.
GOUT
ARTHRITIS

12. What is a GOUT? What is a GOUT ARTHRITIS?
GOUT is a form of ARTHRITIS.
GOUT ARTHRITIS is an ARTHRITIS caused by
deposition of uric crystals on the joint.
GOUT = GOUT ARTHRITIS
ARTHRITIS is inflammation of a joint or several
joints.
Note: Not all ARTHRITIS are due to GOUT. There
are other causes of ARTHRITIS such as
osteoarthritis and rheumatoid arthritis.
GOUT
ARTHRITIS

13. What is the cause of GOUT
ARTHRITIS?
GOUT ARTHRITIS is caused by
too much uric acid in the
blood (hyperuricemia) that
leads to deposition of uric
crystals in a joint or several
joints causing inflammation.
GOUT
ARTHRITIS

14. What is hyperuricemia? What are the causes?
Hyperuricemia occurs when uric acid levels in the blood are too high.
Uric acid is produced when the body breaks down a chemical called
purine.
Purine occurs naturally in your body, but it's also found in certain foods.
Uric acid is eliminated from the body in the urine.
If the kidneys are unable to clear out uric acid fast enough, there will be
hyperuricemia.
GOUT
ARTHRITIS

15. What is hyperuricemia? What are the causes?
Hyperuricemia occurs when uric acid levels in
the blood are too high.
This elevated level is the result of
• increased production
• decreased excretion of uric acid
• or a combination of both processes
GOUT
ARTHRITIS

16. What is hyperuricemia? What are the causes?
URATE OVERPRODUCTION
• PURINE RICH DIET
• AN ERROR OF PURINE METABOLISM: hypoxanthine
phosphoribosyltransferase (HPRT) deficiency,
phosphoribosylpyrophosphate (PRPP) synthetase over
activity
• CELL BREAKDOWN OR TURNOVER: lymphoproliferative
diseases, myeloproliferative disease, polycythemia vera,
Paget disease, psoriasis, tumor lysis, hemolysis,
rhabdomyolysis, EXERCISE
GOUT
ARTHRITIS

17. What is hyperuricemia? What are the causes?
DECREASED URIC ACID EXCRETION
ACUTE OR CHRONIC KIDNEY DISEASE, acidosis
(lactic acidosis, ketoacidosis), hypovolemia,
MEDICATION/TOXIN (DIURETIC, NIACIN,
PYRAZINAMIDE, ETHAMBUTOL, CYCLOSPORIN,
BERYLLIUM, SALICYLATES, LEAD, ALCOHOL),
sarcoidosis, hyperparathyroidism,
hypothyroidism, Bartter syndrome, Down
syndrome
GOUT
ARTHRITIS

18. What are the side effects of hyperuricemia?
High uric acid levels in the bloodstream or
hyperuricemia can cause
• GOUT ARTHRITIS
• KIDNEY STONES
GOUT
ARTHRITIS

19. What are the risk factors for GOUT ARTHRITIS?
• More common in MEN than in WOMEN.
• WOMEN are more likely to get it
after menopause.
• Overweight
• Alcohol
• Family history of gout
• Maintenance medicines such as diuretics (water
pills) that help with high blood pressure
• Metabolic syndrome such as high blood
pressure, high cholesterol, diabetes, or heart
disease
GOUT
ARTHRITIS

20. What are the modifiable causes of hyperuricemia
that one can avoid to prevent GOUT ARTHRITIS?
• Overweight and obesity
• Increase in consumption of
• sugar-sweetened beverages
• foods rich in purines
• Alcohol
GOUT
ARTHRITIS

21. What joints are usually
affected by GOUT ARTHRITIS?
Usually, big toe
but may affect other joints
like ankle, knee, hand, wrist,
and elbow
GOUT
ARTHRITIS

22. What are the phases / stages of GOUT
ARTHRITIS?
Gout progresses through four clinical phases:
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
GOUT
ARTHRITIS
00:00
Majority of people have asymptomatic
hyperuricemia because of excessive purine-rich
food intake.

23. What are the phases / stages of GOUT
ARTHRITIS?
Gout progresses through four clinical phases:
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
GOUT
ARTHRITIS
00:00

24. What are the phases / stages of GOUT
ARTHRITIS?
Gout progresses through four clinical phases:
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
GOUT
ARTHRITIS
00:00
TOPHI

25. What are the phases / stages of GOUT
ARTHRITIS?
Gout progresses through four clinical phases:
• asymptomatic hyperuricemia
• acute gout arthritis
• intercritical gout (intervals between acute
attacks)
• chronic tophaceous gout
GOUT
ARTHRITIS
00:00
TOPHI

26. When to suspect GOUT ARTHRITIS?
Doctors usually diagnose gout based on your
symptoms and the appearance of the affected
joint.
Other confirmatory diagnostic tests may be
needed.
GOUT
ARTHRITIS
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27. How to recognize and diagnose GOUT?
Typical symptoms of GOUT ARTHRITIS (in acute
attack):
Sudden attacks of severe pain, often with
redness and swelling around the joint, most
commonly in the big toe.
GOUT
ARTHRITIS

28. When to suspect GOUT ARTHRITIS?
NOT all joint pains with swelling and
inflammation are GOUT ARTHRITIS.
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
GOUT
ARTHRITIS
00:00

29. When to suspect GOUT ARTHRITIS?
NOT all joint pain, swelling and inflammation are
GOUT ARTHRITIS.
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
GOUT
ARTHRITIS
00:00

30. When to suspect GOUT ARTHRITIS?
NOT all joint pain, swelling and inflammation are
GOUT ARTHRITIS.
One has to differentiate GOUT ARTHRITIS from
two other common arthritis, OSTEOARTHRITIS
and RHEUMATOID ARTHRITIS.
GOUT
ARTHRITIS
00:00

31. When to suspect GOUT ARTHRITIS? How to differentiate from other
ARTHRITIS?
GOUT – usually big toes (with acute inflammation) and with GOUT
FLARES.
Presence of TOPHI (chalk-like substance).
OSTEOARTHRITIS – usually with pain but not as intense and gradual as
GOUT; morning stiffness and disappearing after movement; pain on
movement; asymmetrical joint involvement.
RHEUMATOID ARTHRITIS – symmetrical joint involvement (bilateral)
GOUT
ARTHRITIS
00:00

32. When to suspect GOUT ARTHRITIS? How to differentiate from
other ARTHRITIS?
GOUT – usually big toes (with acute inflammation) and with
GOUT FLARES.
Presence of TOPHI.
OSTEOARTHRITIS – usually with pain but not as intense and
gradual; morning stiffness and disappearing after movement;
pain on movement; asymmetrical joint involvement.
RHEUMATOID ARTHRITIS – symmetrical joint involvement
(bilateral)
GOUT
ARTHRITIS
00:00

33. When to suspect GOUT ARTHRITIS?
Confirmatory tests:
• Joint fluid test to look for urate crystals.
• Blood test to measure the levels of uric acid in
your blood (Blood test results can be
misleading, though. Some people have high
uric acid levels, but never experience gout.)
• X-ray imaging to rule out other causes of joint
inflammation.
• Ultrasound to detect urate crystals in joints or
in tophi.
GOUT
ARTHRITIS
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34. What is the management of GOUT ARTHRITIS?
• Acute attacks – pain medications (NSAIDs –
Nonsteroidal anti-inflammatory drugs)
• Intercritical period – medications to lower uric
acid in blood (with implementation of
strategies against modifiable factors of gout)
• Chronic gout with tophi formation – watch
and wait (with uric acid reduction measure) or
surgery if needed.
GOUT
ARTHRITIS
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35. What is the management of GOUT ARTHRITIS?
Prescription Medicines
• NSAIDs (Non-steroidal Anti-inflammatory
Drugs) reduces pain and inflammation.
• Allopurinol reduces uric acid production.
• Febuxostat reduces uric acid production.
• Colchicine reduces inflammation.
GOUT
ARTHRITIS
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36. What is the management of GOUT ARTHRITIS?
Surgery may at times be done for chronic gout
with tophi.
GOUT
ARTHRITIS
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37. What is the management of GOUT ARTHRITIS?
Foods to Avoid
Stay away from these types of food:
•Beer and grain liquors (like vodka and whiskey)
•Red meat, lamb, and pork
•Organ meats, such as liver, kidneys, and glandular meats like the thymus
or pancreas
•Seafood, especially shellfish like shrimp, lobster, mussels, anchovies,
and sardines
•High-fructose products like soda and some juices, cereal, ice cream,
candy, and fast food
GOUT
ARTHRITIS
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38. What is the management of GOUT ARTHRITIS?
Best Foods for a Gout Diet (low-purine diet
options):
•Low-fat and nondairy- fat products, such as
yogurt and skim milk
•Fresh fruits and vegetables
•Nuts, peanut butter, and grains
•Potatoes, rice, bread, and pasta
•Eggs (in moderation)
•Meats like fish, chicken, and red meat are fine
in moderation
GOUT
ARTHRITIS
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39. What is the management of GOUT ARTHRITIS?
Drinks in GOUT
Do’s
• Drink lots of fluids -- 8 to 16 cups a day. At least half should be water.
Don’ts
• Stay away from sugary drinks like soda and fruit juice.
• Limit or avoid alcohol.
GOUT
ARTHRITIS
00:00

40. Is there a cure for arthritis (gout, osteo,
rheumatoid)?
There is no cure for arthritis.
The treatment goal is to limit pain and
inflammation and preserve joint function.
Treatment options include exercise, weight
reduction, eat-in moderation especially purine-
rich foods, medicines and surgery if needed.
GOUT
ARTHRITIS

41. Be always in touch with reliable medical
information on GOUT ARTHRITIS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on GOUT ARTHRITIS
in your health management.
Take Away in
relation to
Patient
Empowerment
GOUT
ARTHRITIS

42. Contents
• What is a GOUT? What is a GOUT ARTHRITIS?
• What is the cause of GOUT ARTHRITIS?
• What is hyperuricemia? What are the causes?
• What are the side effects of hyperuricemia?
• What are the risk factors for GOUT ARTHRITIS?
• What are the modifiable causes of hyperuricemia that
one can avoid to prevent GOUT ARTHRITIS?
• What joints are usually affected by GOUT ARTHRITIS?
• What are the phases / stages of GOUT ARTHRITIS?
• When to suspect GOUT ARTHRITIS? How to
differentiate from other ARTHRITIS?
• What is the management of GOUT ARTHRITIS?
• Is there a cure for arthritis (gout, osteo, rheumatoid)?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of other
professionals and
ROJoson.
GOUT
ARTHRITIS

43. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.

44. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

45. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

46. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

47. GOUT
ARTHRITIS
Empowerment
objective - for
laypeople to have an
essential
understanding of
GOUT ARTHRITIS in
their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!