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Acute gout — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareAcute goutUSMLE Step 3

A 51-year-old man presents with sudden pain and swelling of the first metatarsophalangeal joint. He had a similar episode 1 year ago. Temperature is 37.3 C. The joint is erythematous and very tender. Serum creatinine is 0.9 mg/dL. He takes hydrochlorothiazide. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Treat with oral NSAID therapy

Acute gout in a patient without renal impairment can be treated with an NSAID; urate-lowering strategy is addressed after acute control.

Reference: ACR gout guideline; USMLE Step 3 Content Outline