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Acute gout flare — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareAcute gout flareUSMLE Step 3

A 55-year-old man develops sudden severe pain, swelling, and erythema of the first metatarsophalangeal joint. Temperature is 37.2 C, creatinine is 0.9 mg/dL, and joint fluid shows negatively birefringent crystals with no organisms. 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: D — Treat with naproxen

Acute gout is treated with an NSAID, colchicine, or glucocorticoid after infection is excluded and contraindications are considered.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials