Rheumatology: gout: practice question

A General Medicine 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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General Medicine · Rheumatology: gout

Sample item

A patient develops abrupt severe pain, erythema, and swelling of the first metatarsophalangeal joint after a heavy meal and alcohol intake. Which crystal is most likely found in aspirated fluid?

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

The answer and the reasoning

B. Needle-shaped negatively birefringent monosodium urate crystals

Gout results from monosodium urate crystal deposition and often presents as acute podagra. Polarized microscopy shows needle-shaped, negatively birefringent crystals.

Option by option

  • A. Cholesterol crystals

    Cholesterol crystals are not the classic finding in acute podagra.

  • B. Needle-shaped negatively birefringent monosodium urate crystals (correct)

    Correct. This crystal morphology is diagnostic of gout.

  • C. Calcium oxalate crystals

    Calcium oxalate crystals are relevant to some kidney stones and toxic ingestions.

  • D. Rhomboid-shaped positively birefringent CPP crystals

    CPP crystals are associated with pseudogout and are typically rhomboid and positively birefringent.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Needle-shaped negatively birefringent monosodium urate crystals. Gout results from monosodium urate crystal deposition and often presents as acute podagra.

Why is "Cholesterol crystals" not the answer?

Cholesterol crystals are not the classic finding in acute podagra.

Why is "Calcium oxalate crystals" not the answer?

Calcium oxalate crystals are relevant to some kidney stones and toxic ingestions.

Why is "Rhomboid-shaped positively birefringent CPP crystals" not the answer?

CPP crystals are associated with pseudogout and are typically rhomboid and positively birefringent.

What concept does this question test?

It tests Rheumatology: gout in General Medicine. Polarized microscopy shows needle-shaped, negatively birefringent crystals.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Rheumatology: gout?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.