Raju, a 30-year-old male presents to the OPD with sudden onset pain, swelling and redness of the left first metatarsophalangeal joint. A needle aspirate of the joint shows needle-shaped, negatively birefringent crystals. The physician prescribed a drug for the patient, but he came back next day with nausea, vomiting and diarrhea after taking the medication. Which of the following is the most likely drug that was prescribed to this patient?

**Core Concept**
The patient's symptoms and needle aspirate findings are indicative of gout, a form of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joint. The prescribed medication is likely an NSAID or colchicine, which are used to manage acute gout attacks.

**Why the Correct Answer is Right**
The patient's symptoms of sudden onset pain, swelling, and redness of the joint, along with the presence of needle-shaped, negatively birefringent crystals in the joint aspirate, are diagnostic of gout. The prescribed medication, colchicine, is used to alleviate the pain and inflammation associated with acute gout attacks. Colchicine works by inhibiting microtubule polymerization, which reduces neutrophil migration and subsequent inflammation.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because indomethacin, while an NSAID, is used to treat gout but is not the most likely cause of the patient's gastrointestinal side effects.
* **Option B:** This option is incorrect because prednisolone, a corticosteroid, is used to treat gout but is not typically associated with the patient's symptoms of nausea, vomiting, and diarrhea.

**Clinical Pearl / High-Yield Fact**
Colchicine can cause gastrointestinal side effects, such as nausea, vomiting, and diarrhea, particularly at high doses. This is due to its mechanism of action, which involves inhibiting microtubule polymerization, leading to disruption of the gastrointestinal epithelial lining.

**Correct Answer:** C. Colchicine.

✓ Correct Answer: B. Colchicine