Return to course: NICE CKS Question Banks
Previous Lesson
Previous
Next
Next Section
Gout (PG)
Return to
Course Curriculum
1. What is the first-line treatment for an acute gout attack in primary care?
*
Allopurinol
NSAIDs (e.g., naproxen)
Opioids (e.g., codeine)
Steroids (oral prednisolone)
2. When should urate-lowering therapy (ULT) be considered?
*
After two or more attacks, or with tophi/renal impairment
Only if serum uric acid >600 µmol/L
After the first attack only
Never in primary care
3. What is the target serum uric acid level on ULT?
*
<420 µmol/L
<360 µmol/L
<300 µmol/L
<500 µmol/L
4. Which lifestyle factor may help reduce gout attacks?
*
Increased red meat intake
Weight gain
Increased shellfish intake
Weight loss
5. Which is the first-line ULT recommended by NICE?
*
Febuxostat
Colchicine
Allopurinol
Probenecid
6. How should allopurinol be initiated?
*
At 300 mg/day directly
At 100 mg/day and titrate up
Only after 3 gout attacks
With a 3-month steroid course
7. What is a key test before starting allopurinol?
*
LFTs
U&Es and eGFR
HbA1c
FBC
8. Which prophylactic treatment may be used when starting ULT?
*
Paracetamol
Aspirin
Prednisolone
Colchicine
9. When should uric acid be re-checked after starting ULT?
*
1 week
4–6 weeks
6 months
Annually only
10. What is the typical joint affected first in gout?
*
Knee
Ankle
1st MTPJ
Hip
11. Which foods should be limited in gout?
*
Shellfish
Grapefruit
Wholegrains
Leafy greens
12. Tophi are associated with:
*
Acute gout only
Vitamin deficiency
Viral infection
Chronic hyperuricaemia
13. In acute gout, what is a key non-pharmacological measure?
*
Elevation and rest
Joint massage
Joint immobilisation
Strenuous exercise
14. What is a common side effect of colchicine?
*
Drowsiness
Rash
Gastrointestinal upset
Headache
15. Which drug can precipitate gout?
*
Paracetamol
Metformin
Aspirin
Ramipril
16. What serious differential diagnosis should be considered alongside gout
*
Septic arthritis
Rheumatoid arthritis
Plantar fasciitis
Morton's neuroma
17. Which imaging can confirm crystal deposits in joints?
*
X-ray
CT
Ultrasound
MRI
18. How long should ULT be continued after symptom control is achieved?
*
6 months
Until urate <360 µmol/L for 6 months
Until 2 years symptom-free
Indefinitely
19. Which NSAID is commonly used in acute gout?
*
Naproxen
Diclofenac
Ibuprofen
Aspirin
20. Which condition must be monitored closely when using NSAIDs in gout?
*
Renal impairment
Hyperthyroidism
Glaucoma
Asthma