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Acute gout — MRCGP AKT MCQ

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HardRheumatologyAcute goutMRCGP AKTUKMLAMRCP Part 1PARAPSA

A patient taking stable allopurinol develops an acute gout flare. What should happen to the urate-lowering medicine?

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Correct answer: DContinue allopurinol and add suitable anti-inflammatory flare treatment

The best answer is “Continue allopurinol and add suitable anti-inflammatory flare treatment”. Established urate-lowering therapy is continued during a flare because interruption destabilises urate and may provoke further attacks. The flare receives an NSAID, colchicine or corticosteroid according to comorbidity. Allopurinol is not an analgesic and its maintenance dose is not briefly doubled for acute symptom control.

Reference: NICE NG219: Gout — diagnosis and management: https://www.nice.org.uk/guidance/ng219/chapter/Recommendations