American Board of Internal Medicine (ABIM) Certification Practice Exam

What is commonly used to treat severe ulcerative colitis?

1. Oral glucocorticoids like prednisone

2. Antibiotics

3. 5-ASA medications

4. Dietary changes

The correct answer is: Oral glucocorticoids like prednisone

Severe ulcerative colitis often requires the use of oral glucocorticoids, such as prednisone, as a primary treatment option. These medications are powerful anti-inflammatory agents that can rapidly reduce inflammation in the colon, alleviating symptoms and inducing remission in patients experiencing severe disease flares. The use of glucocorticoids is particularly common in cases where patients have not responded adequately to aminosalicylates or 5-ASA medications, which are typically used for milder forms of ulcerative colitis. In cases of severe ulcerative colitis, more aggressive management is warranted, and glucocorticoids play a crucial role in controlling inflammation and preventing complications associated with the disease. While other treatment options exist, such as antibiotics, 5-ASA medications, and dietary changes, they are not first-line treatments for severe exacerbations. Antibiotics may be used if there's a concern for secondary infections, 5-ASA medications are more effective in maintaining remission rather than treating severe flares, and dietary changes are often supportive but not curative in the acute setting.