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Hyperkalaemia — MRCP Part 1 MCQ

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HardRenalHyperkalaemiaMRCP Part 1MRCEM SBAUKMLAPARAPSA

A 25-year-old of Turkish ancestry has genetically supported familial Mediterranean fever with monthly self-limiting fever, serositis and raised serum amyloid A between attacks. Renal function is normal. Which long-term treatment best prevents both attacks and AA amyloidosis?

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Correct answer: E — Daily colchicine continued between attacks

The best answer is “Daily colchicine continued between attacks”. Continuous colchicine is the foundation of familial Mediterranean fever treatment. It reduces inflammatory attacks and, critically, suppresses ongoing serum amyloid A exposure that drives AA amyloidosis; it must be taken between attacks. Starting it only once fever begins is too late for prevention. Repeated corticosteroid bursts, allopurinol and delayed azathioprine do not provide the established amyloid protection. Persistent inflammation despite adherence prompts specialist dose review and consideration of IL-1 blockade.

Reference: NHS Genomics Education Programme, Familial periodic fever syndromes: https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/familial-periodic-fever-syndromes/