Gout Tophus. Watch to find out why this used to be called the "Disease of Kings" Dermpath Made Easy скачать в хорошем качестве

Gout Tophus. Watch to find out why this used to be called the "Disease of Kings" Dermpath Made Easy

This is the disease of Kings. This is a gouty tophus, a collection of uric acid crystals in the form of monosodium urate crystals. Gout is a disease that usually presents as an excruciating form of inflammatory arthritis, classically on the big toe. The joint is typically very tender, hot, and red. Occasionally, gouty tophi may involve skin and soft tissue. Gout is due to a dysfunction in purine metabolism in which there are elevated blood levels of uric acid. In the simplest of terms, there is either a problem in the ability of the kidneys to remove purine (most common) or there is a surplus (overproduction) of purine. 1. Kidneys excrete less purine: kidney disease or diuretic use (for hypertension/congestive heart failure) 2. Overproduction of purine - myeloproliferative disease + chemo = lots of cell death and excess purine; inherited enzymatic defects cause accumulation of purine. Many of the pleasures in life may also contribute to gout development: alcohol, fructose-sweetened drinks, meat, and seafood. This is why gout was historically called "The disease of Kings." Microscopically: The uric acid crystals in gouty tophi require alcohol fixation and water free processing because the crystals are water soluble and disappear with formalin fixation. In properly fixed tissue, the crystals are needle-shaped brown crystals. There is usually a granulomatous reaction with giant cells surrounding the urate crystals. Fibrosis and chronic inflammation are also common findings. If you have benefited from this video and want to see more, please hit that like button. All my content is free. All I ask is that you hit that like button, subscribe and share this with others. That's the thing that keeps me producing this content - the knowledge that I am helping someone. Turn notifications on, but you don’t want to miss these short and fun tutorials. SUBSCRIBE TO DR MICHAEL LEE’S YOUTUBE CHANNEL    • Discover What Poison Ivy Rash Looks L...   What was the thing you liked most about this video? Was it too long, short, or just right? Comment below. I read all the comments and if you want a specific topic discussed, that’s the best place to do it. I POST DAILY EDUCATIONAL / ENTERTAINMENT VIDEOS ON SKIN RELATED CONDITIONS **CONNECT WITH DR MICHAEL LEE ON SOCIAL MEDIA** Instagram:   / mpleemd   Twitter: https://twitter.com/mpleemd?lang=en Facebook:   / mpleemd