American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication is considered first-line therapy for mild to moderate ulcerative colitis?

1. 5-ASA drugs

2. Biologics

3. Glucocorticoids

4. Immunosuppressants

The correct answer is: 5-ASA drugs

5-ASA drugs, also known as 5-aminosalicylic acid, are considered first-line therapy for mild to moderate ulcerative colitis due to their effectiveness in reducing inflammation in the colonic mucosa. These medications work locally in the intestines to inhibit the production of inflammatory mediators and promote healing of the intestinal lining. Their use is based on a strong body of evidence supporting their safety and efficacy, making them a preferred option for managing mild to moderate cases. They are typically well tolerated, having a favorable side effect profile compared to other classes of medications. This makes them ideal for long-term management in patients with ulcerative colitis at this stage of the disease. The other types of medications mentioned in the choices are not first-line therapies specifically for mild to moderate ulcerative colitis. While biologics are effective treatments for more severe cases or those not responding to typical therapies, they are not the initial treatment choice for mild cases. Glucocorticoids are commonly used for their potent anti-inflammatory effects, but they are usually reserved for more severe flares due to potential side effects with long-term use. Immunosuppressants are also considered for patients with more severe disease or those who do not adequately respond to first-line