Gout: ABFM practice questions

6 board-style questions on gout in the PulseMD family medicine question bank, 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 55-year-old man presents to the emergency department with acute onset of severe pain, redness, and swelling of his right first MTP joint that began 8 hours ago. He has no history of gout. His temperature is 37.2C, and the joint is exquisitely tender with overlying erythema. Serum uric acid is 9.2 mg/dL. Joint aspiration reveals negatively birefringent, needle-shaped crystals under polarized microscopy with a WBC count of 32,000/mcL. He has no history of kidney disease, peptic ulcer disease, or heart failure. What is the most appropriate treatment?

  1. Probenecid 500 mg twice daily
  2. Indomethacin 50 mg three times daily for 5-7 days
  3. Febuxostat 40 mg daily
  4. Allopurinol 100 mg daily to lower uric acid

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. Initiate allopurinol at 100 mg daily with concurrent colchicine prophylaxis, titrating to a target serum uric acid of less than 6 mg/dL
  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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