A 45-year-old man presents with acute onset hot, swollen first metatarsophalangeal joint. Joint aspiration shows needle-shaped, negatively birefringen...

Question

A 45-year-old man presents with acute onset hot, swollen first metatarsophalangeal joint. Joint aspiration shows needle-shaped, negatively birefringent crystals; cultures are pending. What is the MOST appropriate acute treatment if there are no contraindications?

Accepted Answer

High-dose NSAID (e.g., naproxen) with gastroprotection

Answer

Start allopurinol immediately and withhold anti-inflammatories

Answer

Low-dose aspirin

Answer

Long-term colchicine only without initial loading

Answer

Oral antibiotics pending culture

ca-mccqe1 MCQ (SBA): Acute gout

A 45-year-old man presents with acute onset hot, swollen first metatarsophalangeal joint. Joint aspiration shows needle-shaped, negatively birefringent crystals; cultures are pending. What is the MOST appropriate acute treatment if there are no contraindications?