Question:
Gout can be precipitated by all of the following EXCEPT:
Gout can be precipitated by all of the following EXCEPT:
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Salicylates are biphasic: low doses retain urate, but high doses are uricosuric.
Updated On: Jun 24, 2026
- Thiazides
- Furosemide
- Cyclosporine
- High dose salicylates
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The Correct Option is D
Solution and Explanation
Step 1: Gout is precipitated by drugs that raise serum uric acid (hyperuricemia). Diuretics such as thiazides and loop diuretics (furosemide) reduce renal urate excretion and cause hyperuricemia, so options a and b can precipitate gout.
Step 2: Cyclosporine (and tacrolimus) decrease renal urate clearance and are a well known cause of drug-induced hyperuricemia, so option c can also precipitate gout.
Step 3: Salicylates have a dose-dependent effect on urate. Low doses (0.3 to 3.0 g/day) cause urate retention and hyperuricemia, but HIGH doses (greater than 3.0 g/day) are uricosuric and actually lower serum uric acid. Therefore high-dose salicylates do NOT precipitate gout.
Step 4: The exception, and the correct answer, is high dose salicylates, option d.
Step 2: Cyclosporine (and tacrolimus) decrease renal urate clearance and are a well known cause of drug-induced hyperuricemia, so option c can also precipitate gout.
Step 3: Salicylates have a dose-dependent effect on urate. Low doses (0.3 to 3.0 g/day) cause urate retention and hyperuricemia, but HIGH doses (greater than 3.0 g/day) are uricosuric and actually lower serum uric acid. Therefore high-dose salicylates do NOT precipitate gout.
Step 4: The exception, and the correct answer, is high dose salicylates, option d.
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