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Ulcerative colitis flare — USMLE Step 2 CK MCQ

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HardInternal MedicineUlcerative colitis flareUSMLE Step 2 CK

A 44-year-old Asian American woman comes to the hospital because of abdominal pain or gastrointestinal symptoms. History and focused examination are notable for bloody diarrhea, urgency, continuous rectal inflammation, and negative stool studies. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate pharmacotherapy?

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Correct answer: B — Oral mesalamine for mild to moderate disease

The vignette describes Ulcerative colitis flare, supported by bloody diarrhea, urgency, continuous rectal inflammation, and negative stool studies. Oral mesalamine for mild to moderate disease is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: American College of Gastroenterology 2019 Ulcerative Colitis Guideline