A 58-year-old man presents with acute onset severe pain, redness and swelling of his first metatarsophalangeal joint. This is his first episode. Joint...

Question

A 58-year-old man presents with acute onset severe pain, redness and swelling of his first metatarsophalangeal joint. This is his first episode. Joint aspiration confirms monosodium urate crystals. What is the most appropriate management regarding urate-lowering therapy?

Accepted Answer

Do not start allopurinol during the acute attack; treat the acute gout and consider urate-lowering therapy later

Answer

Start allopurinol immediately at a high dose

Answer

Allopurinol is contraindicated in gout

Answer

Delay treatment of the acute attack until allopurinol has been commenced

Answer

Start probenecid as first-line during the acute attack

au-amc MCQ (SBA): Acute gout and urate-lowering therapy

A 58-year-old man presents with acute onset severe pain, redness and swelling of his first metatarsophalangeal joint. This is his first episode. Joint aspiration confirms monosodium urate crystals. What is the most appropriate management regarding urate-lowering therapy?