gout

Practice targeted AMC-style multiple-choice questions on gout.

A 59-year-old with recurrent gout, on multiple medications, has started allopurinol and naproxen. The uric acid level is 0.58. What is the target uric acid level?

A. Less than 0.40 mmol/L

B. Less than 0.30 mmol/L

C. Less than 0.36 mmol/L

D. Less than 0.20 mmol/L

E. Less than 0.50 mmol/L

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A 45-year-old man presents to the clinic with a 2-week history of a painful, swollen left knee. He denies any trauma or fever. On examination, the knee is warm, swollen, and tender with a limited range of motion. Aspiration of the knee joint reveals cloudy fluid with a white blood cell count of 50,000/mm³ and needle-shaped crystals that are negatively birefringent under polarized light microscopy. What is the most appropriate initial treatment for this condition?

A. Allopurinol

B. Corticosteroid injection

C. Antibiotics

D. Colchicine

E. Nonsteroidal anti-inflammatory drugs (NSAIDs)

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A 56-year-old gentleman, a gardener and cat owner, presents with 24 hours of pain, swelling, and redness on his right index finger. His temperature is 38.1°C and pulse is 72. Suspected gout. What is the most appropriate next step?

A. Aspirate joint for microscopy and culture.

B. Urgent hospital referral for drainage and IV antibiotics.

C. Prescribe oral antibiotics and review in 24 hours.

D. Start diclofenac TDS and discuss allopurinol.

E. Order serum uric acid level.

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gout

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