Gout

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Gout is an inflammatory, crystalline arthritis characterized by the deposition of monosodium urate crystals in the first metatarsophalangeal joint (MTP)...The Crystals are needle-shaped, and negatively birefringent.
Gout and hyperuricemia are not exactly the same thing.
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[@Anaranjado]

I much prefer watching a detailed, energized, and colorful summary of disease processes than falling asleep to a 10 minute video of someone reciting the first aid book. Thank you for these videos 👍

[@MedicosisPerfectionalis]

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[@MedicosisPerfectionalis]

Thank you so much 😊

[@joemcmillan2089]

Very informative, humorous - I enjoyed thoroughly. I'm a 71 YO with a 30 year gout history. For first several years I followed MD's orders, took prescribed drugs, stayed away from numerous foods/drinks. The results were not good so I stopped the MD and the prescription drugs. Began regimen of natural items: Started w/dark cherry juice and ACV. Over time added turmeric, fresh lemon juice/pulp. cinnamon. black pepper, celery seed extract, garlic along with staying away from high purine foods/drinks. Results better than MD and pharma drugs but still had attacks. Finally went to lowcarb/highfat and keto diet. Results have been excellent - pain and swelling gone first week. Although not fat or hypertension, weight has dropped several pounds and blood pressure reduced. Sleep is better. I believe that SUGAR was the bad guy BUT, I enjoy the lowcarb/highfat keto diet so I will continue on. I also dislike any type of drugs so I am happy to be away from them.

[@mustanggt5713]

How are your Uric acid levels now ? You don’t take any drugs like allopurinol at all ?

[@joemcmillan2089]

@@mustanggt5713 I have no idea what my uric acid levels are - I do not go to doctors for over 10 years now. Gout attacks have been gone for 2-1/2 years since going to low carb diet. Blood pressure and weight have both decreased. I take no drugs other than an occasional ibuprofen for various pain.

[@d_2344]

8:48 😂😂😂😭😭 I won’t forget septic arthritis ever , really great explanation ❤️‍🔥

[@MedicosisPerfectionalis]

Thank you ☺️

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You are really doing a great job in teaching! Please keep it up and I hope we still get to access most of your videos for free because they're just all so helpful. You integrate important concepts well with your style in teaching/learning. Thank you so much for this, you're one of the best out there!

[@MedicosisPerfectionalis]

Thank you so much 😊 I really appreciate it! Most of my videos will always be free!

[@safa5678]

Measure 24 hours urinary excretion of Uric acid. It's ranges (250-750 mg)/24 hours. >750 with symptoms meaning- Increase intake by food or overproduction, kidney function well. 250-750 with symptoms meaning- Underexcretion. Please corrected if I wrong. Thank you very much for your video.

[@majdmuhannad7254]

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[@abbybluemusic]

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[@MedicosisPerfectionalis]

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laughed

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[@MedicosisPerfectionalis]

You're always welcome!

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Binge watching your videos before exam is my idea of revision

[@MedicosisPerfectionalis]

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[@MedicosisPerfectionalis]

My pleasure 😇

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[@MedicosisPerfectionalis]

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The best way of learning and get the bigger picture of a concept at a single go. God bless you!

[@MedicosisPerfectionalis]

Thank you! God bless you too!

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I m in love with uur way of teaching

[@MedicosisPerfectionalis]

Thank you 🙏 It means a lot!

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You getting me through my med school! Thank you so much 🥳

[@MedicosisPerfectionalis]

My pleasure!

[@shaleen25]

Learning from this was SO MUCH FUN. Thank you so much !

[@TheAkaaChan]

Haha I'm German and had to laugh when you talked about beer as a risc factor, love your humour

[@MedicosisPerfectionalis]

Thank you ☺️ You’re so kind!

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Not a training doctor, I barely understand what you're talking about but if your videos can get an uneducated idiot like me to get all answers about Homer Simpson's questions right just from the info you provided then this stuff must be gold to the people who need it.

[@MedicosisPerfectionalis]

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[@Roon864]

Make more videos plz ; u dont know how amazing u r ! ,very very helpful

[@MedicosisPerfectionalis]

Thank you so much 😊

[@barthinaghabrial34]

What the heck was i doing before finding yohe videos You're the best out there .. THANK YOU ❤❤❤❤❤

[@MedicosisPerfectionalis]

Thank you so much, Barthina! I appreciate you! Would you please help me by sharing?

[@barthinaghabrial34]

Done ❤

[@amanathun8794]

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[@MedicosisPerfectionalis]

Thank you!

[@hanniequoka]

I love your lectures so much thank you sm it makes studying so much easier ✨

[@MedicosisPerfectionalis]

Thank you 😊

[@darrenrodrigues5962]

If the pain is patient has Gout and the pain is 9/10 is it ok to do a joint fluid aspirate. That patient wouldnt even want you touch that toe let alone put a needle in there.

[@MedicosisPerfectionalis]

You have to rule out septic arthritis first. If this is a patient with a known medical history of gout, and today presents with severe pain in the big toe, the odds are overwhelming that this is gout...In this case, I might go with the doctor judgement. The same concept applies in a completely different case (anal fissure)...The doctor must perform a physical exam first, even though the patient won’t let you touch it. The solution is to perform the physical exam under anesthesia. But you gotta diagnose first before you can treat.

[@darrenrodrigues5962]

@@MedicosisPerfectionalis Thanks a lot for clearing the doubt. Please keep posting more videos they are really helpful. 👍

[@melav9951]

By estimation of uric acid in urine, if the test was positive then the patient is overproducer. if negative; he is under-excretor. Not sure tho

[@Dr.KMaryamA]

Just causally started your video and God damn this shit is so hott gotta grab my pen and journal cant miss it out

[@MedicosisPerfectionalis]

I am so delighted to hear this! Thank you for watching!

[@dream_catcher430]

Thank you for the amazing video! Super helpful and thorough, funny as well I love it 😄

[@ahmedosama5279]

Great great lecture.. the best rheumatology course ever. very nice man

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[@MedicosisPerfectionalis]

Thank you ☺️

[@ken355555]

Thank you now you have explained why I have gout in my knee because I was in the middle of the fast it was almost like starvation and it was definitely dehydration so my knee flared out with a gout attack thank you for pointing that out I was wondering how the hell that happened in the middle of a fast 😀

[@MedicosisPerfectionalis]

I wish you all the best!

[@notsofiltered.3222]

I freaking love your styleeeeee.....

[@MedicosisPerfectionalis]

Thank you 🙏

[@mohammadwaleed860]

Please explain shortly You just repeat the same things again and again . Like what is HGPRT how does it cause Hyperuricemia just a few words about it and your videos will be much more complete ❤

[@natarajanmanickam5119]

Thank u it was very helpful

[@MedicosisPerfectionalis]

Glad it helped!

[@shalinibhandari4904]

It's absolutely amazing.. hope can have more lessons

[@MedicosisPerfectionalis]

Thanks 🙏 More lessons are coming!

[@khanduwangchuk5362]

Looks like my teachers are Dinosaurs! 🤣

[@MedicosisPerfectionalis]

Haha 😂

[@vishalvermaphysio]

sir not able to find your video on treatment of gout thanks and regards

[@levocetirizine4910]

A possible mistake in the vignette is that u cannot do a joint aspiration in a patient with acute gouty attack with pain 9/10. We try to diagnose it with colchicine. Either wait till pain resolves or side effects like diarrhoea start.

[@MedicosisPerfectionalis]

You’re right. It’s just an exam question, not an actual patient. But, fair enough! You’re sharp!

[@levocetirizine4910]

@@MedicosisPerfectionalis I'm just following my text and your text must be inline with the American standards. Me and my friends love your videos! Stay safe and keep going!♥️

[@melav9951]

"Joint aspiration can give pain relief in acute gout " Davidson 23rd edition

[@anik382]

Thank you so much for sharing it for free

[@MedicosisPerfectionalis]

My pleasure 😇

[@kotiyaswanthchowdary5745]

I am confused high level of niacin helps in recovering or it worsen the condition ?

[@cjodyssey]

niacin competes with uric acid for secretion by kidney tubules and raises serum uric acid levels by 5%-15%

[@kotiyaswanthchowdary5745]

@@cjodyssey tq

[@misbah2905]

WOW!!!!! It is too good. I love your videos.

[@MedicosisPerfectionalis]

Thank you so much 😊

[@mahnoorchaudhry4488]

you are awesome , cant get enough of these videos

[@MedicosisPerfectionalis]

Thank you so much 😊

[@cedricmusangu4370]

Why havn't i already smoked your variety? nice ellustration

[@leymer13]

Thanks for this video Medicosis

[@MedicosisPerfectionalis]

You're very welcome 😊

[@user-hd9gu6iw6l]

Diabetes Mellitus is frequently associated with hyperuricacidemia. Is there any corelation?

[@Vinaykumar-ug4gm]

nice video gout ke problem k liyey agar hum planet ayurveda k gioly capsules use karty hain toh hum apni problem ko bhout jldi bilkul thek kr skty hain without side effcet k

[@rekhakadam6393]

Impressed...!! 👏🏼. Covered the entire topic with the freaking details of it..!!! 😅

[@MedicosisPerfectionalis]

Thank you so much ☺️

[@kathryndoh5773]

Can this uric acid cause symptoms of uti

[@kathryndoh5773]

I do have hematomicrosis

[@DoctorClips.]

I have been trying to get to the Rheumatology Playlist but l can’t find it on your channel ..... May l have the link anyone ???

[@MedicosisPerfectionalis]

Hey 👋 Tafadzwa, How are you doing? Here’s the link to my rheumatology playlist: goo.gl/xfJKL1/ Anytime you want to reach any playlist: type in these words in the KZbin search bar: “Medicosis + Playlist + Rheumatology”. Good luck 🍀

[@DoctorClips.]

@@MedicosisPerfectionalis thanks sooo much !

[@abhikhare3144]

Love it

[@MedicosisPerfectionalis]

Thank you!

[@777WOY]

Thanks for the information I look on your page for anyting for restoring blood vessels from neuropathy I've been free from alcohol HalleluYahuah for going on four years for the past year has gotten better but my feet were hurting with Titans and someone said it might be neuropathy I don't receive any of it I believe that I can be healed in Yahusha and my body will restore itself but I have to do my part follow instructions and eat right and drink lots of freshwater just wondering if you did any teaching on healing of blood vessels in the feet?

[@sarahmina1442]

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[@user-wv7se3ko9x]

The holy medicosis Thank you ❤️

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Hey hey hey the best notification to start a day GOOD MORNINGGG♥️ Like & comment before watching😂🤍

[@MedicosisPerfectionalis]

Good morning ☀️ Thank you so much 😊

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Thank you and hello from Jordan 🌹

[@MedicosisPerfectionalis]

👋

[@FD8NI]

just on perfect time!

[@MedicosisPerfectionalis]

Thanks 😊

[@nargizsafarova6595]

thank you

[@MedicosisPerfectionalis]

My pleasure 😇

[@desertedham37]

your videos are so great!

[@BushraAliKhanB]

Love this video!! Thank you, Just a question isnt Apirin a Risk Factor buy in High doses not in low doses, we can safely give pt low dose Apirin for anti platelet effect. Please do confirm

[@TUM3541]

why does gout hurt more at night?

[@MedicosisPerfectionalis]

At the end of the day, there is more pressure on the weight-bearing joints (remember the flask experiments and the crystals).

[@TUM3541]

@@MedicosisPerfectionalis Thank you, Doctor 💟

[@rockycycle2682]

I'm trying to like all the videos that I watch. Thank you so much, if I were the type to pay for free stuff I'd definitely pay, but I'm too stingy I suppose. One day isA 😭

[@MedicosisPerfectionalis]

No worries, my friend! Thank you so much 😊

[@themuleify]

While the information is great and thank you for this and other videos, the causes of gout as you explain are so frikin' confusing. All sources point to excessive uric acid (either over production or under secretion), but not always as Hyperuricemia is not Gout, right. So if gout attacks can occur while uric acid level is LOWWWW lol:) then why do we need to prescribe Allopurinol to lower it even more? And when reduced, does that guarantee no gout attacks again? And if I get another attack while taking Allopurinol and uric acid level is low, then what is to blame? (Of course while making all dietary changes as well). Just trying to understand the rational here.

[@KittysAreCute]

I was wondering that too. Maybe uric acid levels in the blood during an attack might be normal or low because instead of the uric acid circulating freely throughout the body’s blood, it is concentrated as crystals in a joint?

[@themuleify]

@@KittysAreCute In extreme cases I guess it could be possible. But it would be a large amount deposited in the joints. Let's say the normal level for gout is 6mg/dL. That means the total 8n the blood is around 300mg (based on 5 liter of blood for adults). So if the level at the time of the attack say was 7.4mg/dL, but when tested it was under 6, it means the total fluids in the joints would have to be about 70mg. What my Dr was able to draw from my toe was about 2mg.

[@KittysAreCute]

@@themuleify Good point. I was bewildered and more intrigued. I googled "why normal uric acid during gout attack" and found Bădulescu M, Macovei L, Rezuş E. Acute gout attack with normal serum uric acid levels. Rev Med Chir Soc Med Nat Iasi. 2014 Oct-Dec;118(4):942-5. PMID: 25581951. "Results: Normal serum uric acid levels were found in 63.3% of the patients with acute gout attack. The inflammatory syndrome was detected in 76.6% of patients with high erythrocyte sedimentation rate (ESR) levels and in 30% of patients who had elevated C-reactive protein levels. The urinary excretion of uric acid was measured in 11 patients and it was found increased in 55% of them. "Conclusions: The diagnosis of acute gout attack should not be excluded in the presence of normal serum uric acid levels if the clinical manifestations or the positive response at colchicine are suggestive of gout. The low uric acid level is correlated with increased inflammatory factors and urinary excretion of uric acid."

[@user-hd9gu6iw6l]

IL6 generated at the inflamed joint has uricosuric action.

[@user-hd9gu6iw6l]

Similar example:Many cases of myocardial infraction occur even when LDL level is normal. Probably endothelial damage invites cholesterol to get deposited there.

[@joymutheu7737]

😂😂😂😂ooh lord am enjoying this

[@MedicosisPerfectionalis]

I am so glad! Would you please help me by sharing?

[@user-tq5zu9em9v]

Why you will do Arthrocentesis& joint fluid analysis at 1st even before giving NSAIDs or Allopurinol, Guy? 1.To rule out septic arthritis 2.To rule out septic arthritis 3.To rule out septic arthritis It is an emergency case! 4.To confirm Diagnosis...

[@muhadninmhanafi9694]

My HEROOOOOOOOO

[@BedeliaMikk]

Is ankylosing spondylitis an oligoarthritis, or poly?

[@BedeliaMikk]

@@bobby-my7uc thank you!

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he is 100% perfect, i like you

[@MedicosisPerfectionalis]

Thank you so much 😊

[@user-zt2by4cn6m]

Really i liked But You saying: “oh shut up “ soooo much 😂🥸 Thank u. ♡

[@MedicosisPerfectionalis]

Thank you for your honest feedback!

[@judith4096]

you are incredible

[@MedicosisPerfectionalis]

Thank you 😊

[@michaelchen2638]

hi, just have a question. Wouldn't foods such as red meat, seafood and beer cause an overproduction of uric acid as opposed to under excretion of uric acid since there is more purine to metabolise in the body. I am not quite sure about this, hope you can help with my confusion

[@MedicosisPerfectionalis]

Yes! I made a mistake in the illustration.

[@mynameisalexanderhamilton2862]

Thanks! Love from PH 🥰

[@MedicosisPerfectionalis]

My pleasure 😇

[@moonlightegypt750]

ماهو الفريكن...what is freaken meaning?.❤❤❤

[@yadavratna]

Loved it 🤟🏻

[@MedicosisPerfectionalis]

Thank you 🙏

[@ramyabachu9900]

Pleasure make a video on SLE in detail like RA. Thank you. I am a rheumatology aspirant.

[@MedicosisPerfectionalis]

Thank you 🙏 I will try my best!

[@laasyagogula4565]

could you talk about cholinergic urticaria?

[@BieberGirl474]

Did you make a video on the seronegative spondyloaritis? I can’t find it anywhere

[@MedicosisPerfectionalis]

It’s here: www.medicosisperfectionalis.com/products/p/ankylosing-spondylitis-1/

[@nightjadeOR]

I thought primary gout was more common than secondary?

[@mah5688]

i love u man thanks

[@MedicosisPerfectionalis]

My pleasure 😇

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Woow woow woow 🤩

[@MedicosisPerfectionalis]

Thank you 🙏

[@MrSaloha]

Good morning 🌞

[@Wise_fool1704]

U teach freaking good 😊

[@MedicosisPerfectionalis]

Thank you 🙏

[@WVgrl59]

Toes, knees, feet...it affects many joints.

[@babinasab1039]

I really like your vidéo you are an imaizing pr

[@MedicosisPerfectionalis]

Thank you so much 😊

[@medabd8133]

Ans- By 24 hr urine examination... If urine uric acid excretion is greater than 800mg/dl👍

[@medabd8133]

Overproducer*

[@newmedicoscience2355]

Haemolytic anemia how can increase the uric acid bz RBCs dont have nucleus ?Can u explain me please 🙏

[@MedicosisPerfectionalis]

Don’t ignore the nucleated RBC precursors (e.g., proerythroblasts, erythroblasts,…etc)…In response to hemolytic destruction, the bone marrow will make more of these cells, which will eventually die.

[@sayedelboghdady5436]

perfect

[@MedicosisPerfectionalis]

Thanks 🙏

[@Mariamhamwi]

Where can I find a pdf for this please?

[@Mariamhamwi]

THANK you for making medicine MAKE sense.. I always comment on your videos. I wont stop.

[@aryan2065]

Very very thankful. ❤️ and 🙏

[@MedicosisPerfectionalis]

Thank you 😊

[@sanatantawi8205]

amazingggggg explanation thanks

[@MedicosisPerfectionalis]

My pleasure 😇

[@miraq3261]

Legend

[@MedicosisPerfectionalis]

Thanks 🙏

[@unaiskv6477]

What about chronic Gout??

[@MedicosisPerfectionalis]

What about it?

[@merowaell]

awesome💜💜💜💜

[@MedicosisPerfectionalis]

My pleasure 😇

[@baselsharan9912]

16:51

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Why is the pl-ease giving dr.cox vibes ?

[@alaawy25]

waiting for part 3 0f COVID-19series ....

[@MedicosisPerfectionalis]

Thanks for letting me know! I will try

[@mikepoteet1443]

I am suffering from gout right now and it sucks! It is super painful and I haven't been able to all week long.

[@user-kt1hj8hm7c]

good

[@MedicosisPerfectionalis]

Thank you!

[@narandetagenblirtillluft1419]

Amazing 🌷🌷🌷🌷

[@tamilpandiyanbalachandran2438]

Do i get premium videos by joining membership to your channel?

[@MedicosisPerfectionalis]

Yes, You get some of them. For more details, please send me an email at [e-mail]