10-25-2011, 05:14 AM
A 63-year-old man presents to the hospital with an extremely painful right big toe. He reports that the pain started last night and was unrelieved by pain medication. He denies any trauma to the toe. On exam, the right first metatarsophalangeal joint is red, swollen and extremely painful to palpation. Aspiration of the swollen joint reveals long, needle-shaped, negatively birefringent crystals under polarized light. Appropriate treatment is started, and the patient is told to avoid aspirin. For which of the following reasons is aspirin likely contraindicated in this patient?
A. Aspirin reduces renal clearance of uric acid
B. Aspirin does not provide analgesia
C. Aspirin mobilizes uric acid from body stores
D. Aspirin is inferior to nonsteroidal anti-inflammatory drugs for analgesia
E. Aspirin increases renal clearance of uric acid
A. Aspirin reduces renal clearance of uric acid
B. Aspirin does not provide analgesia
C. Aspirin mobilizes uric acid from body stores
D. Aspirin is inferior to nonsteroidal anti-inflammatory drugs for analgesia
E. Aspirin increases renal clearance of uric acid