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Ulcerative colitis — MCCQE Part 1 MCQ

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ModerateDiarrheaUlcerative colitisMCCQE Part 1

A 42-year-old woman has recurrent crampy abdominal pain and bloody diarrhoea x 6 months. Colonoscopy: continuous mucosal inflammation from rectum to splenic flexure, pseudopolyps, crypt abscesses. Most appropriate initial therapy?

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Correct answer: D — Oral and rectal 5-ASA (mesalamine)

Left-sided UC: combined oral+rectal 5-ASA first-line. More effective than either alone. Steroids for moderate-severe or 5-ASA failure. Key UC feature: continuous inflammation from rectum.

Reference: CAG UC Guidelines