Increased uric acid levels are found in

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Biochemistry & Nutrition

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Gout is a form of inflammatory arthritis directly caused by high levels of uric acid in the blood, a condition known as hyperuricemia.
Uric acid is the final waste product of purine metabolism. When the body produces too much or the kidneys fail to excrete enough, its levels rise.
This excess uric acid can precipitate into sharp, needle-like monosodium urate crystals within a joint or surrounding tissue, triggering intense pain, inflammation, and swelling.
The causal link between high uric acid and the development of gout is a well-established pathophysiological mechanism.

Option B: Wilson disease is an autosomal recessive genetic disorder characterized by the accumulation of copper in the body, particularly in the liver, brain, and eyes. It is a disorder of copper metabolism, not purine metabolism, and does not primarily cause elevated uric acid.
Option C: Fanconi syndrome is a disorder of the proximal renal tubules where the kidneys fail to reabsorb various solutes, including glucose, amino acids, phosphate, and uric acid. This leads to excessive urinary excretion of uric acid, resulting in low blood levels (hypouricemia), which is the opposite of the condition described.
Option D: Yellow atrophy of the liver, or acute massive hepatic necrosis, is a condition of severe and rapid liver failure. While the liver is involved in producing uric acid, acute failure is not a characteristic cause of hyperuricemia. The primary findings would be drastically elevated liver enzymes, jaundice, and coagulopathy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causes of hyperuricemia as background academic context rather than a clinical decision trigger.
Nurses are central to managing gout through patient education on lifestyle modifications, including a low-purine diet (avoiding organ meats, red meat, certain seafood) and limiting alcohol and fructose intake.
A key nursing role is to encourage adequate hydration (2-3 liters per day) to promote renal excretion of uric acid and prevent the formation of kidney stones, a common complication of hyperuricemia.
During an acute gout attack, nurses administer pain relief (NSAIDs, colchicine), apply cold compresses, and educate the patient to rest and elevate the affected joint to reduce swelling and pain.

How to Approach the Question

This is a factual recall question that tests your knowledge of the pathophysiology of specific metabolic and genetic diseases.
First, identify the core concept in the question stem: 'Increased uric acid levels' (hyperuricemia).
Next, systematically review each option and recall its primary pathological feature.
Option A, Gout, is the classic disease defined by hyperuricemia and its consequences. This is a strong candidate.
Option B, Wilson disease, is related to copper metabolism. Eliminate it.
Option C, Fanconi syndrome, involves renal wasting of solutes, which would cause low uric acid (hypouricemia). Eliminate it as it's the opposite.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 991-993