Gout: rasburicase: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Gout: rasburicase

Sample item

A child with Burkitt lymphoma starts chemotherapy and is at high risk of tumour lysis syndrome with a rapidly rising uric acid. Which agent most rapidly lowers uric acid by breaking it down?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Rasburicase

Rasburicase is recombinant urate oxidase that converts uric acid to the soluble allantoin, giving a fast fall in urate. It is contraindicated in G6PD deficiency because the hydrogen peroxide produced can cause haemolysis.

Option by option

  • A. Allopurinol

    Allopurinol only reduces new uric acid formation and acts more slowly.

  • B. Probenecid

    Probenecid is a uricosuric and is unsuitable when uric acid load is massive, as it risks nephropathy.

  • C. Rasburicase (correct)

    Correct. Urate oxidase degrades existing uric acid.

  • D. Febuxostat

    Febuxostat also reduces production and does not clear existing urate quickly.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Rasburicase. Rasburicase is recombinant urate oxidase that converts uric acid to the soluble allantoin, giving a fast fall in urate.

Why is "Allopurinol" not the answer?

Allopurinol only reduces new uric acid formation and acts more slowly.

Why is "Probenecid" not the answer?

Probenecid is a uricosuric and is unsuitable when uric acid load is massive, as it risks nephropathy.

Why is "Febuxostat" not the answer?

Febuxostat also reduces production and does not clear existing urate quickly.

What concept does this question test?

It tests Gout: rasburicase in Pharmacology. It is contraindicated in G6PD deficiency because the hydrogen peroxide produced can cause haemolysis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gout: rasburicase?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.