Alcohol Gout CKD Advice — ESENeph MCQ
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Correct answer: E — Discuss alcohol moderation and offer treat-to-target urate-lowering treatment
The best answer is “Discuss alcohol moderation and offer treat-to-target urate-lowering treatment”. NICE recommends treat-to-target urate lowering for multiple or troublesome flares and CKD. Alcohol, weight, medicines and cardiovascular risk are discussed without implying that one dietary factor replaces pharmacological prevention. “Use dietary measures while assessing indications for urate-lowering treatment” is less appropriate because CKD requires dose-aware treatment but is not a contraindication “Discuss beer reduction because beer can contribute to hyperuricaemia and flares” is less appropriate because beer and spirits can raise urate and trigger flares “Recommend alcohol abstinence when it aligns with the patient’s broader health goals” is less appropriate because absolute abstinence is not the universal requirement and does not replace urate control “Treat acute flares while also assessing the need for long-term prevention” is less appropriate because frequent flares meet a strong indication for urate-lowering therapy
Reference: NICE NG219: gout diagnosis and management: https://www.nice.org.uk/guidance/ng219/chapter/Recommendations