American Board of Internal Medicine (ABIM) Certification Practice Exam

What is crucial for the management of scleroderma renal crisis?

1. A calcium channel blocker

2. An ACE inhibitor

3. High-dose glucocorticoids

4. Diuretics

The correct answer is: An ACE inhibitor

The correct answer highlights the importance of an ACE inhibitor in managing scleroderma renal crisis. This condition often involves rapid onset renal failure due to severe hypertension, which can lead to significant morbidity and mortality. ACE inhibitors play a vital role in treating the hypertension associated with this crisis by inhibiting the angiotensin-converting enzyme, leading to vasodilation and decreased blood pressure. This not only helps in controlling hypertension but also has a renoprotective effect. Moreover, the use of ACE inhibitors has been shown to improve renal function in patients experiencing scleroderma renal crisis. Their effectiveness in reducing proteinuria and stabilizing renal function makes them a cornerstone in the management of this condition, particularly when compared to other options, which may not address the underlying hypertension and associated renal issues as effectively.