<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 45-year-old man with a history of recurrent gouty arthritis comes to the physician for a follow-up examination. Four weeks ago, he was diagnosed with hyperuricemia and treatment with allopurinol was begun. Since then, he has had another acute gout attack, which resolved after treatment with ibuprofen. His temperature is 37.1C 98.8F. Physical examination shows painless, chalky nodules on the metatarsophalangeal joint of his right foot. Laboratory studies show:SerumCreatinine 1.0 mgdLUric acid 11.6 mgdLCholesterol 278 mgdLUrineUric acid 245 mg24 h N 240-755Based on the urine findings, this patient would most likely benefit from treatment with which of the following drugs to prevent future gout attacks?? A: Rasburicase, B: Probenecid, C: Indomethacin, D: Prednisolone, E: Colchicine,  <response>: This is a patient with recurrent gouty arthritis who is currently being treated with allopurinol. He recently had another gout attack despite being on allopurinol. His uric acid level is elevated at 11.6 mgdL normal is 3.5-7.2 mgdL for men. His 24 hour uric acid excretion is normal at 245 mg24 hrs. The goal of therapy in gout is to reduce serum uric acid levels to prevent crystal formation and dissolve existing crystals. Since this patients uric acid production is normal based on his 24 hour urinary excretion, his elevated serum uric acid is likely due to underexcretion. The choices given are different medications used to treat gout. Rasburicase is used to lower extreme elevations in uric acid but would not be appropriate for long term management. Indomethacin and colchicine are anti-inflammatory agents used to treat acute gout flares but do not lower uric acid. Prednisolone is a steroid also used for acute flares. Probenecid increases uric acid excretion by blocking reabsorption in the renal tubules. Since this patient has normal production but likely underexcretion of uric acid, probenecid would be the best choice to increase his excretion and lower his serum uric acid level.B: Probenecid 