American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is treated by the use of carbonic anhydrase inhibitors?

1. Multiple sclerosis

2. Chronic migraines

3. Idiopathic intracranial hypertension

4. Pneumonia

The correct answer is: Idiopathic intracranial hypertension

Carbonic anhydrase inhibitors are primarily used in the treatment of idiopathic intracranial hypertension (IIH), a condition characterized by increased pressure within the skull without an identifiable cause. These medications, such as acetazolamide, work by reducing the production of cerebrospinal fluid (CSF), thereby decreasing intracranial pressure. In IIH, the elevated pressure can lead to various neurological symptoms, including headaches and vision issues. By inhibiting the enzyme carbonic anhydrase, these drugs decrease the bicarbonate and fluid secretion in the choroid plexus, ultimately helping to relieve symptoms and prevent complications, such as vision loss. While the other conditions listed have specific treatments and management strategies, they are not typically treated with carbonic anhydrase inhibitors. For example, multiple sclerosis is managed with disease-modifying therapies; chronic migraines often require preventive medications, such as beta-blockers or antidepressants; and pneumonia is generally treated with antibiotics. Thus, the application of carbonic anhydrase inhibitors is specifically relevant and beneficial in the context of idiopathic intracranial hypertension.