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This Concept Map, created with IHMC CmapTools, has information related to: Gout Biochem Map.Edited, PRPP synthetase to form PRPP, Uric acid which accumulates in blood, release of lysosomal enzymes in Joint synovium, cellular destruction in Joint synovium, IMP converted to AMP, monosodium urate monohydrate which form tophi (needle shaped crystals), GMP is converted by 5'-nucleotidase to Inosine, acute gouty arthritis manifests as Erythematous. warm, tender to touch with decreased ROM, GMP leading to decreased levels of available substrates, cellular mechanisms for breakdown of Purines, cellular mechanisms for breakdown of pyrimidines, Febuxostat inhibits Xanthine Oxidase, blood manifests as hyperuricemia, tophi (needle shaped crystals) which are Negatively bifringent with polarized light, Purines begins with AMP, Erythematous. warm, tender to touch with decreased ROM contributes to diagnosis of Secondary Gout, hyperuricemia consistent with serum uric acid level: 8.8 mg/dl, Erythematous. warm, tender to touch with decreased ROM resulting in Great toe pain x1 day, decreased GFR (glomerular filtration rate) leadng to decreased excretion of Uric acid, patient lifestyle - excessive dietary intake of foods rich in Purines