A 46-year-old woman presents with sudden onset severe pain, redness and swelling in the first metatarsophalangeal joint. She drinks alcohol regularly ...

Question

A 46-year-old woman presents with sudden onset severe pain, redness and swelling in the first metatarsophalangeal joint. She drinks alcohol regularly and is overweight. Joint aspiration shows needle-shaped negatively birefringent crystals. What is the most appropriate first-line treatment of this acute attack?

Accepted Answer

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

Answer

Long-term allopurinol immediately

Answer

Intra-articular steroid injection only

Answer

Long-term colchicine prophylaxis only

Answer

Immediate urate-lowering therapy with febuxostat

uk-plab-1 MCQ (SBA): Acute gout