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Acute Gout — ABIM Board MCQ

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ModerateRheumatologyAcute GoutABIM Board

A 35‑year‑old man presents with a gout flare of less than 24‑hour duration and has normal renal function. Which of the following initial regimens is guideline‑concordant?

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Correct answer: A — Colchicine 1.2 mg immediately, then 0.6 mg one hour later, then 0.6 mg once or twice daily until flare resolves

Option A is correct: it uses the FDA‑approved colchicine dosing for acute gout flare and aligns with the 2020 ACR guideline recommendation for early, low‑dose colchicine therapy with continuation until resolution. Option B is incorrect because initiating urate‑lowering therapy during an acute flare without anti‑inflammatory prophylaxis may worsen the flare. Option C is inappropriate: chronic prednisone is not indicated for prevention, especially without addressing acute inflammation. Option D is false: NSAIDs are a first‑line option unless contraindicated. Option E misdiagnoses the condition and leads to inappropriate antibiotic use.

Reference: 2020 American College of Rheumatology Gout Management Guideline; FDA Colcrys Prescribing Information, https://pmc.ncbi.nlm.nih.gov/articles/PMC10563586/