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  #1  
Old 12-26-2012
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Arrow Billy Step 1 Questions # 95

A 30-year-old man with peptic ulcer disease suddenly develops pain, redness, and swelling of his right first metatarsophalangeal joint. There is no history of injury. Serum uric acid concentration is 8 mg/dL. Examination of joint aspirate shows birefringent crystals. Which of the following drugs is most appropriate to treat the acute symptoms in this patient?


(A) Allopurinol
(B) Colchicine
(C) Morphine
(D) Probenecid
(E) Sulfinpyrazone
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  #2  
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Colchicine
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  #3  
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(B) Colchicine
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Colchicine
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Old 12-26-2012
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Why not Allopurinol?
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Quote:
Originally Posted by billy View Post
Why not Allopurinol?
Allupurinol decrease synthesis of new uric acid but no effect on already formed uric acid or inflammation. Colchine reduction acute inflammation.
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  #7  
Old 12-26-2012
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(B) Colchicine
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Old 12-31-2012
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bt colchicine worsens git symptoms....
then we should gve it....?
one more thing if there was option of indomethacin or other potent NSAID..........then wat ll be DOC along with colchicine...
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Old 12-31-2012
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Colchicine is the answer but I was also confused because it may worsen Git problems
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Old 01-07-2013
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allopurinol is for chronic gout and if the patient has an ulcer u can not give NSAID, so colchicine is the answer
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Old 01-15-2013
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Quote:
Originally Posted by billy View Post
A 30-year-old man with peptic ulcer disease suddenly develops pain, redness, and swelling of his right first metatarsophalangeal joint. There is no history of injury. Serum uric acid concentration is 8 mg/dL. Examination of joint aspirate shows birefringent crystals. Which of the following drugs is most appropriate to treat the acute symptoms in this patient?


(A) Allopurinol
(B) Colchicine
(C) Morphine
(D) Probenecid
(E) Sulfinpyrazone


Colchicine!
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  #12  
Old 01-28-2013
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I think its colchicine. You cannot give allopurinol in acute gout because it will worsen the gout.Allopurinol is only for chronic gout.
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Old 01-28-2013
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ans. colchicine
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  #14  
Old 12-26-2015
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Default Why not morphine?

Why morphine can't be the answer?

It seems less GI distress than Colchicine although constipation doesn't have tolerance.

Is this because of morphine's addiction inducing effect?

Plus, the reason why u can't use allopurinol or probenecid in acute situation is that they could change the concentration of uric acid arbitrarily temporarily, which could lead to exacerbation. So, you need to experience repeated gout attack to be started on those therapies and even then, you must have stabilized uric acid concentration.

The treatment of choice for acute gout attack is NSAID which could not be used here due to patient's PUD.

Last edited by leejunsang88; 12-26-2015 at 06:28 AM. Reason: grammar
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