Terry Cook broke an 88-race victory drought winning the Dodge Ram Tough 200 at Gateway International Raceway. Cook, who went to the emergency room with flu symptoms on Wednesday, recovered sufficiently to bring his Ford F-150 from the eighth starting position to the lead by the 91st of 160 laps. The Ohio native gave up the advantage on the 106th lap in making his final of two pit stops. Cook took over for good when leader Jason Leffler pitted his Dodge 11 laps later. Cook held a 7.5-second lead over Leffler after the pit stop cycle, a margin that grew to 8.564 seconds at the checkered flag. The winner averaged 109.323 mph for 200 miles and earned $52,160 for his first victory since 1998. Pole-winner Mike Bliss finished third in a Chevrolet. Rick Crawford took fourth place despite an early stop to fix a broken oil line that dropped his Ford to 32nd in the 36-truck field. David Starr finished fifth in another Chevy to take over the series points lead, 10 ahead of Ted Musgrave. Dennis Setzer, Jon Wood, Brian Rose, Lance Norick and Matt Crafton completed the top 10, eight of whom completed all 160 laps. Just three caution flags flew to consume 14 laps, with the last ending at lap 48. Six competitors swapped the lead eight times with Cook leading twice for 59 laps. Bliss, Setzer, Wood, Leffler and Musgrave also paced the event.