American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for a patient with familial Mediterranean fever?

1. NSAIDs

2. Colchicine

3. Glucocorticoids

4. Antibiotics

The correct answer is: Colchicine

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disorder characterized by recurrent episodes of fever and serositis. The cornerstone of treatment for FMF is colchicine, which is effective in preventing attacks and reducing the frequency of episodes, as well as preventing long-term complications such as amyloidosis. Colchicine works by inhibiting the inflammatory response associated with the disease. While nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to alleviate pain during an acute attack, they do not address the underlying condition or prevent future episodes. Glucocorticoids may also be utilized but are not the first line of treatment and are generally reserved for cases that are unresponsive to colchicine. Antibiotics are not relevant in the treatment of FMF since the condition is not caused by a bacterial infection. Thus, the rationale for choosing colchicine as the recommended treatment lies in its established role in managing the symptoms of FMF and preventing complications associated with the disease.