Nokea
Mr Tan, a 50-year-old with hypertension, sees you for a routine review. He reports three gout flares in the past two months, relieved with three days of Arcoxia for each episode. You perform some blood tests, which result in the following returns: Creatinine 95 umol/L, eGFR >90 mL/min, Uric acid 460 mmol/L, HbA1c 5.4 percent, Random hypo-count 7.5 mmol/L. He is currently on Amlodipine 10 mg OM. He does not drink alcohol except one glass of wine once or twice a year on special occasions. His BMI is 20.5 kg/m². Which is the most appropriate next step?
Correct Answer: C
Rationale: Three gout flares in two months uric acid 460 beg for urate-lowering therapy like allopurinol, with colchicine to dodge attacks, fitting >2 flares yearly guideline. NSAIDs or steroids treat, not prevent; diet and exercise tweak, not tame, this level. Clinicians push this combo, curbing chronic gout's fire, a proactive leap.