<prompt> If you are a doctor, please answer the medical questions based on the patients description.Male aged 66 weight 120 Kg -reducing at 1 Kg per week as diuretic takes effect. Cushings, Conn s, Ulcerative Colitis, Diabetes 2. Bone density OK. New Problem of concern is Unilateral ankle pain and swelling for over three weeks, causing limp, no fever, feels like a sprain but no accident or bruise discolouration. Prone to gout but on 300 mg Allopurinol per day. SOB, fatigue, mobile pitting edema, probably due to incipient diabetic nephropathy - Bumetanide 2 x 1mg per day. CBC - All mmolL- Serum Corrected Calcium low 2.15, Urea 10.6, Cholesterol 4.5. Creatinine 156 umolL, Parathyroid high 13.6 pmolL, GFR 36. Various anemia indicators contradict - Ferritin 163 ngmL, RBC 4.23, Haematocrit 0.409, MCV 96.7 fl, MCH 30.7 pg, RCDW 14.4, MCHC 318 gL, Neutrophils 7.66 x 109L, Lymphocytes 1.44. Vit D3 8 ngmL Urine Albumin:Creatinine Ratio 0.5 mgmmol  <response>: I understand your symptoms and complaint. Diuretics efficiency may be decreased. Past history and blood urea is more than normal and indicate uncontrolled gout case. First, Applying cold bath on foot, compression band on foot and topical anti-inflammatory cream. Increase water intake and decrease salt intake. Continuous uric acid analysis should be monitored every 3 weeks. Take analgesic and anti-inflammatory tablets 3 times daily for one week. 