Review Question - QID 106643

This man presents with an acute attack of gout; he was treated with colchicine, which acts by decreasing microtubule polymerization.

Gout results from intra-articular deposition of monosodium urate crystals. Deposited uric acid crystals can activate neutrophils and the complement cascade, which leads to the symptoms of the acute attack. Hyperuricemia may be caused by either increased production or decreased excretion, and there are medications available to target both of these causes of hyperuricemia. Additionally, lifestyle changes, such as alcohol cessation and weight loss, are important in reducing the frequency of attacks.

Figure A shows the classical presentation of acute gout of the great toe (podagra).

Incorrect Answers:
Answer 1: Inhibition of xanthine oxidase is the mechanism of allopurinol.
Answer 2: Probenecid inhibits reabsorption of uric acid in proximal convoluted tubule.
Answer 3: Nonselective inhibition of cyclooxygenase (COX) 1 and 2 is the mechanism of NSAIDs, such as indomethacin.
Answer 4: Binding to glucocorticoid receptor is the mechanism of action of glucocorticoids.