A 46-year-old male diagnosed with gouty arthritis is at high risk for developing:

Choice A reason: Nonadherence to the antiviral regimen could lead to a resurgence of HIV symptoms and a higher viral load, but it is not typically associated with the symptoms of increased hunger, thirst, and frequent urination described by the patient.

Choice B reason: Pancreatic infiltration by HIV is a rare complication and would not be the first suspicion in this scenario. While HIV can affect multiple organs, the symptoms described are more suggestive of metabolic issues rather than direct infiltration of the pancreas.

Choice C reason: An allergic reaction to the medication would more likely present with symptoms such as rash, itching, swelling, or difficulty breathing rather than the metabolic symptoms described. Allergic reactions typically do not cause increased hunger, thirst, or frequent urination.

Choice D reason: Hyperglycemia (high blood sugar levels) is the most likely cause of the symptoms described. Protease inhibitors can lead to metabolic side effects, including insulin resistance and hyperglycemia. Symptoms of hyperglycemia include increased hunger (polyphagia), increased thirst (polydipsia), and frequent urination (polyuria). These findings are consistent with the patient's complaints and should be investigated further to manage the side effects of the medication.

Choice A reason: Renal stones, also known as kidney stones, are a common complication of gouty arthritis. Gout is caused by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. High levels of uric acid in the blood can also lead to the formation of uric acid stones in the kidneys. These stones can cause severe pain, urinary obstruction, and increase the risk of urinary tract infections. Therefore, patients with gout are at a higher risk of developing renal stones due to the elevated uric acid levels.

Choice B reason: Cholelithiasis, or gallstones, is not directly associated with gouty arthritis. Gallstones are formed from cholesterol or bilirubin in the gallbladder and are more commonly related to conditions such as obesity, diabetes, and certain liver diseases. While they can cause significant health issues, they are not a typical complication of gout.

Choice C reason: Liver failure is not a common complication of gouty arthritis. While liver disease can occur due to other underlying conditions or as a side effect of medications used to treat gout, it is not directly caused by the elevated uric acid levels or the inflammation characteristic of gout.

Choice D reason: Myocarditis, which is inflammation of the heart muscle, is not typically associated with gouty arthritis. Myocarditis can be caused by infections, autoimmune diseases, or other factors, but it is not a known complication of elevated uric acid levels or gout.