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 Best of Five 25

 

   

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BOF: 25

A sixty five year old male who is on treatment for chronic heart failure with diuretics, angiotensin converting enzyme inhibitors, beta-blockers and spironolactone presents with sudden onset of pain and swelling of the metatarso-phalangeal joint of his right big toe. Aspiration of the joint demonstrates crystals of monosodium urate.

In this patient:

a)      Moderate doses of aspirin would be beneficial

b)      Non-steroidal anti-inflammatory digs would be the drugs of first choice

c)      Highly selective cyclooxygenase 2 inhibitor should be used

d)      Colchicine would be the best choice

e)      Parenteral colchicine may be safely used to counter nausea and diarrhoea

 

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