Gout is a-

BSF Staff Nurse - 2015

Edition 3

Easy

Appeared in: BSF Staff Nurse - 2015

Explanation

Gout is correctly classified as a metabolic disorder because its root cause is an error in the body's purine metabolism.
The condition is defined by hyperuricemia (serum uric acid greater than 6.8 mg/dL), which results from either the overproduction of uric acid or its under-excretion by the kidneys.
Uric acid is the final breakdown product of purines. When its concentration becomes too high, it precipitates as monosodium urate crystals in joints and tissues.
The deposition of these crystals triggers a potent inflammatory response, leading to the characteristic acute attacks of painful arthritis.

Option A: A degenerative disorder involves the progressive breakdown of tissue, such as cartilage in osteoarthritis, due to mechanical stress and aging. Gout is an inflammatory disorder caused by a chemical imbalance (crystal deposition), not structural wear and tear.
Option B: Psychological disorders are conditions that affect a person's thinking, feeling, mood, or behavior, such as depression or anxiety. Gout is a physical, systemic disease related to metabolism.
Option C: Neurological disorders affect the body's nervous system (brain, spinal cord, and nerves). While gout causes intense pain, which is transmitted by nerves, the underlying disease process is not neurological. The pain is a symptom of the metabolic and inflammatory problem.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Gout as background academic context rather than a clinical decision trigger.
Nurses play a key role in educating patients with gout about managing their condition. This includes teaching about dietary restrictions (avoiding high-purine foods like organ meats, certain seafood, and alcohol), the importance of staying hydrated to help kidney function, and medication adherence.
During an acute gout flare, nursing priorities include pain management (administering NSAIDs, colchicine, or corticosteroids as prescribed) and providing comfort measures like elevating and resting the affected joint.
What if? If a patient with gout presents with a fever and a single, swollen, hot joint, it's crucial to consider septic arthritis as a differential diagnosis. Both can coexist. Aspiration of the joint fluid is essential to check for both crystals (gout) and bacteria (infection), as septic arthritis is a medical emergency requiring immediate antibiotics.

How to Approach the Question

First, identify the core concept of the question. The question asks for the fundamental classification of the disease 'gout'.
Recall the basic pathophysiology of gout. The key term associated with gout is 'uric acid'.
Think about where uric acid comes from. It is a waste product from the breakdown of purines. This breakdown process is a chemical reaction within the body, which is the definition of metabolism.
Evaluate the given options in this context. 'Metabolic disorder' directly aligns with an issue in the body's chemical processes (purine metabolism).
Rule out the other options. 'Degenerative' relates to wear and tear (like osteoarthritis). 'Psychological' relates to the mind. 'Neurological' relates to the nervous system. None of these fit the primary cause of gout.
Therefore, based on the link between gout, uric acid, and purine breakdown, 'Metabolic disorder' is the most accurate classification.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 860-862

E6 Biochemistry U Satyanarayana— Part 2 (pp 421-820 of 840) p. 12-14