<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 56-year-old man comes to the physician for a follow-up examination. Two weeks ago, he was treated for an acute gout attack of the metatarsophalangeal joints of his right big toe. His symptoms improved with naproxen. He has had three other similar episodes of joint pain in his toes and ankles during the last year that improved with over-the-counter analgesics. He does not currently take any medications. He used to drink 35 beers daily but has recently cut down. He is a chef at a steakhouse. His temperature is 37.0C 98.6F, pulse is 76min, and blood pressure is 14783 mm Hg. Examination of his right big toe shows minimal tenderness; there is no warmth or apparent deformity. The remainder of the examination shows no abnormalities. His serum creatinine concentration is 0.9 mgdL. Long-term treatment with which of the following drugs is most appropriate to prevent future gout attacks?? A: Colchicine, B: Probenecid, C: Aspirin, D: Pegloticase, E: Allopurinol,  <response>: This is a patient with recurrent episodes of acute gouty arthritis affecting his toes and ankles. He has risk factors of being male, consuming alcohol daily, and eating a diet high in purines from working as a chef at a steakhouse. His physical exam is consistent with an acute gout attack that has resolved. The question asks about long-term treatment to prevent future gout attacks. The choices include colchicine, probenecid, aspirin, pegloticase, and allopurinol. Colchicine treats acute gout flares but does not lower uric acid levels to prevent attacks. Probenecid increases uric acid excretion but is not first-line for prevention. Aspirin does not affect uric acid levels. Pegloticase is used for refractory gout but is not appropriate for initial management. Allopurinol decreases uric acid production and is the most appropriate choice for long-term prevention of gout attacks in this patient.E: Allopurinol 