A patient has had three gout flares in the past year, serum urate 9.4 mg/dL and eGFR 68 mL/min/1.73 m2. The acute flare has resolved. What long-term

Question

A patient has had three gout flares in the past year, serum urate 9.4 mg/dL and eGFR 68 mL/min/1.73 m2. The acute flare has resolved. What long-term strategy is most appropriate?

Accepted Answer

Start allopurinol with flare prophylaxis and titrate to serum urate target

Answer

Offer joint surgery because recurrent flares indicate progressive joint infection

Answer

Use long-term opioids and reserve anti-inflammatory therapy for severe flares

Answer

Prescribe furosemide with hydration advice to enhance urate excretion

Answer

Use dietary counselling and reassess serum urate after six months

Recurrent gout — USMLE Step 3 MCQ

A patient has had three gout flares in the past year, serum urate 9.4 mg/dL and eGFR 68 mL/min/1.73 m2. The acute flare has resolved. What long-term strategy is most appropriate?