American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the effect of budesonide in the management of severe microscopic colitis?

It functions as a potent immune-suppressor
It is used only if anti-TNF therapy fails
It is the first-line treatment
It resolves all inflammatory bowel diseases

The correct answer is: It functions as a potent immune-suppressor

Budesonide is a type of corticosteroid that is specifically designed for localized delivery to the gastrointestinal tract, making it particularly effective in treating conditions such as severe microscopic colitis. The primary mechanism of budesonide involves its ability to reduce inflammation by suppressing the immune response in the affected area. This effect is vital in managing the symptoms associated with microscopic colitis, such as diarrhea and abdominal pain. In the context of treating severe microscopic colitis, budesonide is recognized as the first-line treatment due to its targeted action and favorable side effect profile compared to systemic corticosteroids. It is not merely an immunosuppressor used only after other therapies fail, nor is it a treatment that resolves all forms of inflammatory bowel diseases, as its therapeutic application is specific to certain conditions. Therefore, budesonide plays a pivotal role in effectively managing severe microscopic colitis as part of a comprehensive treatment strategy.