<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old man is brought to the emergency department for worsening pain and swelling of his left ankle for the past 2 hours. The pain is severe and awakened him from sleep. He has hypertension and hyperlipidemia. Current medications include hydrochlorothiazide and pravastatin. His temperature is 37.8C 100.1F, pulse is 105min, and blood pressure is 14896 mm Hg. Examination shows exquisite tenderness, erythema, and edema of the left ankle; active and passive range of motion is limited by pain. Arthrocentesis of the ankle joint yields cloudy fluid with a leukocyte count of 19,500mm3 80 segmented neutrophils. Gram stain is negative. A photomicrograph of the joint fluid aspirate under polarized light is shown. Which of the following is the most appropriate pharmacotherapy?? A: Probenecid, B: Colchicine and allopurinol, C: Triamcinolone and probenecid, D: Colchicine, E: Ketorolac and aspirin,  <response>: This is a clinical vignette describing a patient with an acute inflammatory arthritis of the ankle. Key findings include severe pain, swelling, warmth, and limited range of motion of the ankle. Joint fluid analysis shows an elevated white blood cell count with neutrophil predominance. The photomicrograph of the joint fluid shows negatively birefringent needle-shaped crystals, characteristic of monosodium urate crystals seen in gout. The patient has risk factors for gout including hypertension, hyperlipidemia, male gender, and advanced age. The presentation is most consistent with an acute gout flare. Initial treatment of an acute gout flare involves anti-inflammatory agents to relieve pain and swelling. Colchicine is an anti-inflammatory medication that is effective and appropriate for initial treatment of an acute gout attack. Probenecid, allopurinol, triamcinolone, ketorolac, and aspirin are not first-line agents for acute gout.D: Colchicine 