A patient is diagnosed with gout. What type of food should be given to the patient?

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

Gout is a metabolic disorder characterized by high levels of uric acid in the blood (hyperuricemia), which is a disorder of purine metabolism.
Uric acid is the end product when the body breaks down purines, which are found naturally in the body and in many foods.
A low-purine diet is prescribed to limit the intake of purines, which helps reduce the body's production of uric acid.
Lowering uric acid levels helps prevent the formation of urate crystals in the joints, thereby reducing the frequency and severity of painful gout attacks.

Option B: A high iodine diet is not related to gout management. Iodine is a mineral essential for thyroid hormone production.
Option C: A diabetic diet aims to control blood glucose levels, not uric acid. While some recommendations (like avoiding sugary drinks) are beneficial for both, it is not the specific therapeutic diet for gout.
Option D: An iron-rich diet is used to treat anemia by increasing hemoglobin levels. It has no therapeutic effect on gout and is not part of its management.

Clinical Relevance

Nursing practice connection: Use the key finding related to Dietary management for a patient with gout to guide bedside assessment, documentation, and the next nursing action.
Patient education on diet is a key nursing responsibility in managing chronic conditions like gout to improve outcomes and reduce painful flare-ups.
Nurses should advise patients to increase fluid intake (2-3 liters per day, if not contraindicated) to help flush out excess uric acid through the kidneys.
A crucial point of education is the avoidance of alcohol, especially beer, as it not only contains purines but also impairs the kidney's ability to excrete uric acid.

How to Approach the Question

First, identify the key diagnosis in the question stem, which is 'gout'.
Recall the basic pathophysiology of gout. It is a condition caused by the buildup of uric acid crystals in the joints.
Connect the pathophysiology to its metabolic origin. Uric acid is the breakdown product of purines.
Based on this connection, deduce the logical dietary intervention: to reduce uric acid, one must reduce the intake of its precursor, purines.
Scan the options to find the diet that aligns with this deduction. 'Low purine diet' is the direct and correct answer.
Briefly consider the other options to confirm their irrelevance. A high iodine diet is for thyroid issues, a diabetic diet is for blood sugar control, and an iron-rich diet is for anemia.

Concept Tested & Keywords

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E6 Nutrition Monika Sharma 3e pp. 247-249, 246-248

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 224-226

Practise the full DSSSB -28 August 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.