American Board of Internal Medicine (ABIM) Certification Practice Exam

What medication is often used in conjunction with glucocorticoids for maintaining remission in ulcerative colitis?

1. Azathioprine (AZA)

2. Rifaximin

3. Proton pump inhibitors

4. Salicylates

The correct answer is: Azathioprine (AZA)

Azathioprine (AZA) is commonly used in conjunction with glucocorticoids for maintaining remission in ulcerative colitis due to its immunosuppressive properties. This medication helps to reduce inflammation and prevent flare-ups by modulating the immune response. In patients with ulcerative colitis, glucocorticoids are often prescribed to control acute inflammation and symptoms, but they are not ideal for long-term management due to potential side effects. Azathioprine, a thiopurine analog, plays a crucial role in the long-term management of ulcerative colitis. It not only helps maintain remission but also reduces the frequency and severity of disease exacerbations when used alongside glucocorticoids. This combination can be particularly beneficial for patients who are either unable to achieve remission solely with glucocorticoids or who experience frequent relapses. Other options such as rifaximin, proton pump inhibitors, and salicylates are not primarily used in combination with glucocorticoids for maintaining remission in ulcerative colitis. Rifaximin is primarily indicated for certain gastrointestinal infections and hepatic encephalopathy, while proton pump inhibitors target acid suppression and are not mainstays for ulcerative colitis management. Salicyl