American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary management approach for Sicca symptoms in Sjögren syndrome?

1. Immunosuppressive therapy

2. Symptomatic hydration and lubrication

3. Surgical intervention

4. Radiation therapy

The correct answer is: Symptomatic hydration and lubrication

The primary management approach for Sicca symptoms in Sjögren syndrome focuses on symptomatic hydration and lubrication. Sjögren syndrome is characterized by dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca) due to the autoimmune destruction of exocrine glands. Therefore, alleviating the discomfort associated with these symptoms is essential for improving the quality of life of affected individuals. For dry mouth, treatment options often include using oral moisturizers, saliva substitutes, and medications that stimulate saliva production, such as pilocarpine or cevimeline. In the case of dry eyes, artificial tears and ocular lubricants are typically recommended to relieve dryness and protect the cornea from damage. Other treatments, such as immunosuppressive therapy, may be appropriate for addressing systemic manifestations of Sjögren syndrome, but they do not directly resolve the Sicca symptoms. Surgical intervention is rarely warranted, and radiation therapy is not applicable in the management of Sicca symptoms. The primary focus remains on providing symptomatic relief through hydration and lubrication, making this approach the cornerstone of managing Sicca symptoms in patients with Sjögren syndrome.