Question

a 50 - year - old male presents with sudden onset severe pain and swelling in his left big toe joint. he denies any recent trauma but admits to consuming large quantities of red meat, shellfish, and beer over the weekend. laboratory investigations reveal elevated serum uric acid levels. what is the most appropriate initial management for this patient? please select your answer... a allopurinol b nsaids (nonsteroidal anti - inflammatory drugs) c colchicine d corticosteroids

Explanation:

The patient presents with classic symptoms of acute gout (sudden - onset joint pain, especially in the big toe, elevated uric acid, and a history of purine - rich food and alcohol intake). In the initial management of acute gout, NSAIDs are a first - line treatment. Allopurinol is used for long - term uric acid control and should not be started during an acute attack as it can worsen the attack. Colchicine can be used but has more side - effects (gastrointestinal upset) compared to NSAIDs in many cases. Corticosteroids are an alternative if NSAIDs are contraindicated (e.g., in patients with renal failure or peptic ulcer disease), but NSAIDs are the more appropriate initial choice in the absence of contraindications.

Answer:

B. NSAIDs (Nonsteroidal anti - inflammatory drugs)