A 35-Year-Old Man with a Known History of Peptic Ulcer

question 221

Multiple Choice

A 35-year-old man with a known history of peptic ulcer disease comes to the physician with sudden onset of pain, swelling, and redness at the base of his great toe.  The patient was awakened in the middle of the night by the pain and was unable to go back to sleep.  He has no history of trauma to the joint.  Physical examination shows swelling, erythema, and exquisite tenderness involving the right first metatarsophalangeal joint.  Fine-needle aspiration of the joint shows needle-shaped, negatively birefringent crystals.  After making the diagnosis, the physician prescribes an appropriate medication.  Shortly after starting the medication, the patient develops nausea, vomiting, and diarrhea.  Which of the following is the most likely mechanism of action of the drug prescribed to this patient?

• A)Decreased renal tubular uric acid reabsorption
• B)Inhibition of cyclooxygenase activity
• C)Inhibition of microtubule formation
• D)Inhibition of phospholipase A₂ activity
• E)Inhibition of xanthine oxidase activity

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