Risk factors for developing gout

 

 

 

 

 

 

Description

Scenario: A 47-year-old man presents with pain in his right large toe. The man is overweight and has consumed 12 to 16 beers daily for at least 15 years. His medical history includes hyperlipidemia and a history of gall bladder disease but is otherwise unremarkable. Today’s vital signs include blood pressure 180/96, heart rate 89, respiratory rate 24, Temperature 98.8°F, and pain reported as 8 on 1 to 10 scale. The patient has taken acetaminophen and ibuprofen for pain management with little effect. The patient says this is the first time he has experienced such pain. He has not been diagnosed with gout, arthritis, or other conditions in the past. This pain has prevented him from sleeping for 3 nights, and he appears tired. He also reports difficulty walking and completing his daily responsibilities as a farmer. The patient reports recent trauma to the toe as he dropped a heavy object on it 1 week prior; however, no obvious displacement of the joint or bruising is noted. The practitioner suspects gout is the cause of the man’s condition.

What risk factors does the man have for developing gout?
What contributing factors should be explored with the patient?
What physical assessment should be performed related to the reported pain?
What is the initial testing that should be performed after a physical assessment?
What are the differential diagnoses for this patient?
What modifications should the patient be instructed to make for treatment of the gout?
What is your initial treatment and follow up plan? Include full prescribing information.

 

 

 

Sample Solution

 

 

 

When Was Jesus Born?

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Jesus Christ is one of the most well known figures of history and religion. Despite the fact that the verifiable proof of him living isn’t so generous, there is sufficient information to guarantee he was a genuine individual. In any case, with his reality guaranteed by data outside the Bible, there are as yet numerous secrets about him. One such problem is the point at which he was conceived. Truth be told, “when was Jesus conceived” is a top inquiry on the web. There are numerous speculations about when he was conceived regarding the year and month, and even day. These speculations have been obfuscated by misconceptions, social standards, and an absence of solid proof. In any case, this article will dive into the different speculations behind his birthdate and attempt to get to the base of the inquiry.

In spite of the fact that a great many people commend the introduction of Christ on December 25th as Christmas, most researchers concur this isn’t the date he was conceived. Indeed, as expressed by History.com, “The most established existing record of a Christmas festivity is found in a Roman chronological registry that recounts a Christ’s Nativity celebration drove by the congregation of Rome in 336 A.D. The exact motivation behind why Christmas came to be commended on December 25 stays darken, however most scientists accept that Christmas began as a Christian substitute for agnostic festivals of the winter solstice” (“Christ Is Born?”). In this way, commending his introduction to the world on December 25th was a greater amount of an adjustment to agnostic customs as opposed to an adherence to a definite date.

A few researchers take a gander at the Bible for proof of when he was conceived. For example, LiveScience states that, “A few researchers imagine that he was conceived between 6 B.C. furthermore, 4 B.C., in view of on the scriptural story of Herod the Great. Not well before Herod’s destruction, which is accepted to have happened in 4 B.C., the leader of Judea evidently requested the demise of every single male newborn child who were younger than two and lived in the region of Bethlehem, trying to execute Jesus. However, antiquarians differ about Herod’s genuine year of death” (Castro, Joseph). Likewise, researchers for the most part expect the mass child murder depicted in the Bible to be a legend rather a verifiable truth. What’s more, the Star of Bethlehem elucidated in the Bible showing up on the day Jesus was conceived is now and again associated with a cosmic occasion that occurred on 5 B.C. that was noted by Chinese cosmologists as a moderate moving comet (Castro, Joseph). As a side note, some Bible researchers trust Christ was conceived in the spring or summer because of shepherds looking out for their groups as expressed in the Bible, which would not have occurred in winter.

Shockingly, even PC models have been utilized to compute the time of Jesus’ introduction to the world date dependent on cosmology. As indicated by LiveScience, “In 2008, stargazer Dave Reneke contended that Jesus was conceived in the mid year. The Star of Bethlehem, Reneke disclosed to New Scientist, may have been Venus and Jupiter meeting up to shape a brilliant light in the sky. Utilizing PC models, Reneke verified that this uncommon occasion happened on June 17, in the year 2 B.C.” (Castro, Joseph). In any case, inverse suppositions have been made by researchers, by putting Jesus’ introduction to the world in harvest time with an uncommon galactic occasion occurring at 7 B.C.

At long last, it is for the most part accepted, with certain questions about its precision, that the Roman domain took a statistics during a great time. This evaluation was referenced in the Bible, however it appears there may be blunders as far as dates referenced. In any case, on the off chance that there were a registration during Jesus’ life, at that point there is some proof for the surmised time he was conceived. As per GotQuestions.org, “Quirinius represented Syria during this equivalent timeframe, with records of an enumeration that remembered Judea for roughly 6 B.C. A few researchers banter whether this is the enumeration referenced by Luke, however it appears to be a similar occasion. In light of these recorded subtleties, the most probable time of Christ’s introduction to the world in Bethlehem is 6-5 B.C.” (“What Year Was Jesus Christ Born?”). Accordingly, with some assistance from verifiable records, we can put Jesus’ date of birth as very near the beginning of the A.D. course of events.

Despite the fact that we can’t be sure about Jesus’ season of birth, most researchers accept through chronicled records, the Bible, and stargazing that he was conceived around the hour of 1 AD in either the mid year or spring. There are a huge number of speculations, in spite of the absence of proof that we have. What’s more, along these lines, there may consistently be vulnerability about Jesus’ date and time of birth.

Works Cited

“Christ Is Born?” History.com, A&E Television Networks, 4 Mar. 2010, www.history.com/this-day-ever/christ-is-conceived.

Castro, Joseph. “When Was Jesus Born?” LiveScience, Purch, 30 Jan. 2014, www.livescience.com/42976-when-was-jesus-born.html.

 

 

 

 

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