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Old 12-20-2014
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Default NBME form 7 Questions

Hello. Can anyone help me answer this question on NBME Form 7 section 1 number 32?

A 52 year old man came to the physician because of excruciating pain and swelling of his right great toe since undergoing appendectomy 10 days ago. The pain is so severe that he cannot tolerate his bedsheets to his toe. Treatment with celecoxib has provided no relief. His temperature is 37.5C (99.6F) Examination of the toe show swelling, erythema, and marked tenderness of the metatarsalphalangeal joint. Which of the following is the most appropriate next step in pharmacotherapy?

I had chosen dexamethasone, but my answer was incorrect. My friend had chosen allopurinol, but he got that wrong as well. I know that indomethacin is the first line treatment in gout, but this patient already had no relief with celecoxib, which is why I had chosen the dexamethasone.
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