Jon

A 34-year-old Samoan man presents to the GP clinic with worsening chronic gout. His attacks are more frequent, joints are now persistently sore, and he believes he's allergic to his previous medication. Take a focused joint history, explore lifestyle and family history, examine the affected joints, and formulate an appropriate management plan with attention to Pacific Islander pharmacogenomic considerations.

1. 1Take a focused history of the joint pain including SOCRATES
2. 2Take a detailed alcohol and dietary history
3. 3Explore relevant past medical history including HTN, diabetes, CKD
4. 4Verbalise a focused joint examination
5. 5Order and justify appropriate investigations including HLA-B*5801
6. 6Provide a working diagnosis with relevant differentials
7. 7Counsel on dietary and lifestyle modification
8. 8Initiate urate-lowering therapy with appropriate safety steps