🏥 USMLE Exam Prep

A 48-year-old male presents with acute onset severe pain, swelling, and redness in his right great toe. He denies trauma. He consumes alcohol regularly and reports a similar episode years ago that resolved spontaneously. On examination, the joint is exquisitely tender to touch. Serum uric acid level is 9.5 mg/dL. What is the most appropriate initial pharmacologic treatment for this acute flare?

A Allopurinol
B Colchicine
C Probenecid
D Febuxostat

✓ Correct Answer: Option B

This is an acute gout flare. Colchicine is an effective first-line treatment for acute gout, especially when initiated early. NSAIDs or corticosteroids are also options. Allopurinol, probenecid, and febuxostat are urate-lowering therapies used for long-term prevention and should not be initiated during an acute flare, as they can worsen it.

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