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Gout — UKMLA MCQ

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MediumRheumatologyGoutUKMLAMRCGP AKTMRCP Part 1

A 52-year-old man complains of acute onset severe big toe pain with redness and swelling. Serum uric acid is elevated. What is the most appropriate initial acute treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Oral NSAIDs (e.g., naproxen)

For acute gout attacks, NSAIDs (e.g., naproxen) or colchicine are first-line treatments. Allopurinol or febuxostat are used for long-term urate-lowering therapy, not during the acute attack's initial phase. The keyed option is the best answer only in the stated clinical context. The alternatives would require different findings, contraindications, thresholds or treatment circumstances that are not present. Apply the recommendation alongside comorbidity, interactions, patient preference and the current local pathway. Review response and safety-net for deterioration, treatment failure or adverse effects; reconsider the diagnosis if the expected response does not occur.

Reference: NICE Gout Guideline: https://www.nice.org.uk/guidance/ng219/chapter/recommendations