A 49-year-old man with gout returns 4 weeks after his second flare this year. Symptoms have resolved. Serum urate is 9.2 mg/dL. He has hypertension

Question

A 49-year-old man with gout returns 4 weeks after his second flare this year. Symptoms have resolved. Serum urate is 9.2 mg/dL. He has hypertension treated with hydrochlorothiazide and normal kidney function. Which of the following would you recommend at the follow-up visit?

Accepted Answer

Start urate-lowering therapy with flare prophylaxis

Answer

Prescribe colchicine for 3 days every month

Answer

Use long-term prednisone daily

Answer

Advise high-purine diet to assess triggers

Answer

Begin allopurinol during a future flare without prophylaxis

Gout — USMLE Step 3 MCQ

A 49-year-old man with gout returns 4 weeks after his second flare this year. Symptoms have resolved. Serum urate is 9.2 mg/dL. He has hypertension treated with hydrochlorothiazide and normal kidney function. Which of the following would you recommend at the follow-up visit?