Gout: ABFM practice questions

8 board-style questions on gout in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 52-year-old man presents to the clinic with acute onset of severe pain, swelling, and erythema of his right first metatarsophalangeal joint that began 12 hours ago. He has no prior history of gout and takes hydrochlorothiazide for hypertension. The joint is exquisitely tender, erythematous, and warm. Serum uric acid is 9.2 mg/dL. Joint aspiration reveals negatively birefringent, needle-shaped crystals under polarized light microscopy. He has no history of renal disease, peptic ulcer disease, or heart failure. What is the most appropriate treatment for this acute flare?

  1. Indomethacin 50 mg three times daily for 5-7 days
  2. Probenecid 500 mg twice daily
  3. Allopurinol 100 mg daily with dose titration
  4. Colchicine 1.2 mg followed by 0.6 mg one hour later, started 48 hours after symptom onset

Sample question 2

A 58-year-old man with a history of gout presents for follow-up. He has had 3 acute gout flares in the past 12 months, with his most recent flare 6 weeks ago (now fully resolved). He also has a history of a uric acid kidney stone 2 years ago. His current serum uric acid level is 8.8 mg/dL. He takes no gout-related medications. His eGFR is 72 mL/min and he has no liver disease. According to ACR guidelines, what is the most appropriate long-term management?

  1. Continue observation and treat flares as they occur
  2. Start allopurinol 100 mg daily with colchicine flare prophylaxis
  3. Prescribe daily colchicine 0.6 mg without urate-lowering therapy
  4. Start febuxostat 80 mg daily as first-line urate-lowering therapy

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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