List 4 clinical features of gout Outline the diagnosis of iron deficiency anemia. Outline investigations finding in: I) pleural effusion II) myocardial infarction in ECG Asthma in spirometry.

Clinical features of gout:
1) Sudden onset of severe joint pain, often in the big toe
2) Swelling, redness, and warmth in the affected joint
3) Tenderness and increased pain with movement or pressure on the joint
4) Limited range of motion in the affected joint

Diagnosis of iron deficiency anemia:
1) History and physical examination to assess for symptoms such as fatigue, weakness, pale skin, and shortness of breath
2) Complete blood count (CBC) to check for low hemoglobin and hematocrit levels
3) Serum iron studies to measure levels of iron, ferritin, and transferrin
4) Peripheral blood smear to look for microcytic, hypochromic red blood cells

Investigations findings in:
I) Pleural effusion:
- Chest X-ray showing fluid accumulation in the pleural space
- Thoracentesis to analyze the fluid for characteristics such as protein, lactate dehydrogenase (LDH), and cell count
- Pleural fluid analysis showing exudative or transudative effusion

II) Myocardial infarction in ECG:
- ST-segment elevation or depression
- T-wave inversion
- Q waves indicating necrosis
- Presence of pathological Q waves

Asthma in spirometry:
- Decreased forced expiratory volume in 1 second (FEV1)
- Decreased forced vital capacity (FVC)
- Decreased FEV1/FVC ratio
- Reversibility of airflow obstruction with bronchodilator administration

Clinical Features of Gout:

- Intense joint pain, swelling, and redness (usually in the big toe)
- Warmth and tenderness in the affected joint
- Fever and chills
- Risk factors such as obesity, high blood pressure, and family history

Diagnosis of Iron Deficiency Anemia:

- History and physical exam: Fatigue, weakness, pale skin, nail changes
- Blood tests:
- Low hemoglobin and hematocrit
- Low serum iron
- Elevated transferrin saturation
- Increased erythropoietin levels

Investigations Findings:

I) Pleural Effusion:

- Chest X-ray: Blurring of costophrenic angle
- Ultrasound: Collection of fluid in the pleural space

II) Myocardial Infarction on ECG:

- ST segment elevation: Shows the area of injured heart muscle that has reduced blood flow
- Q waves: Permanent scarring in the affected area
- T wave inversion: Reflects abnormal electrical activity in the heart

III) Asthma on Spirometry:

- Reduced forced expiratory volume in 1 second (FEV1): Measures how much air can be forcefully exhaled in one second
- Reduced forced vital capacity (FVC): Measures the total amount of air that can be exhaled after a full inspiration
- Increased FEV1/FVC ratio: Indicates airway narrowing