🦶(WITH
GOUT – EXAM MASTER SHEET
RATIONALES)
💊THERAPY
1. FIRST-LINE URATE-LOWERING
Q: What is first-line to LOWER uric acid long-term?
✅ Allopurinol
💡➡️ MOA (VERY TESTED):
Xanthine oxidase inhibitor → ↓ uric acid production
⚠️EFFECTS
2. ALLOPURINOL ADVERSE
Q: What are key adverse effects?
✅
Rash (can progress to Stevens-Johnson Syndrome)
GI upset
🔥
Liver toxicity
Bone marrow suppression (rare)
💡👉 TEST TIP:
RASH = STOP DRUG immediately
🧪ALLOPURINOL
3. MONITORING WITH
, Q: What labs should be monitored?
✅
Serum uric acid (goal <6 mg/dL)
Liver function tests (LFTs)
Renal function (Cr, BUN)
CBC
💡 Rationale:
Detect toxicity
Ensure effectiveness
🔥THERAPY?
4. WHAT HAPPENS WHEN STARTING
Q: What happens when allopurinol or febuxostat is initiated?
✅ Acute gout flare
💡➡️ WHY:
Rapid uric acid shifts → mobilizes crystals
🚨 KEY TEST POINT:
👉 DO NOT STOP allopurinol during flare
💊MANAGEMENT
5. ACUTE GOUT FLARE
Q: What are first-line treatments for an acute flare?
✅
GOUT – EXAM MASTER SHEET
RATIONALES)
💊THERAPY
1. FIRST-LINE URATE-LOWERING
Q: What is first-line to LOWER uric acid long-term?
✅ Allopurinol
💡➡️ MOA (VERY TESTED):
Xanthine oxidase inhibitor → ↓ uric acid production
⚠️EFFECTS
2. ALLOPURINOL ADVERSE
Q: What are key adverse effects?
✅
Rash (can progress to Stevens-Johnson Syndrome)
GI upset
🔥
Liver toxicity
Bone marrow suppression (rare)
💡👉 TEST TIP:
RASH = STOP DRUG immediately
🧪ALLOPURINOL
3. MONITORING WITH
, Q: What labs should be monitored?
✅
Serum uric acid (goal <6 mg/dL)
Liver function tests (LFTs)
Renal function (Cr, BUN)
CBC
💡 Rationale:
Detect toxicity
Ensure effectiveness
🔥THERAPY?
4. WHAT HAPPENS WHEN STARTING
Q: What happens when allopurinol or febuxostat is initiated?
✅ Acute gout flare
💡➡️ WHY:
Rapid uric acid shifts → mobilizes crystals
🚨 KEY TEST POINT:
👉 DO NOT STOP allopurinol during flare
💊MANAGEMENT
5. ACUTE GOUT FLARE
Q: What are first-line treatments for an acute flare?
✅