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Gout and CKD — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Gout and CKDUSMLE Step 3

A 60-year-old man with stage 3 CKD has recurrent gout flares and serum urate 9.8 mg/dL. The current flare has resolved. He is not taking azathioprine. Which of the following would you recommend at the follow-up visit?

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Correct answer: C — Start low-dose allopurinol with titration and prophylaxis

Allopurinol can be used in CKD with low starting dose, gradual titration, and flare prophylaxis.

Reference: American College of Rheumatology Gout Guideline