American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of medication may be warranted to reduce fungal colonization in allergic bronchopulmonary aspergillosis?

1. Antibiotics

2. Antifungal agents

3. Bronchodilators

4. Calcium channel blockers

The correct answer is: Antifungal agents

In allergic bronchopulmonary aspergillosis (ABPA), the primary issue is an exaggerated immune response to the colonization of the lungs by the fungus Aspergillus, often Aspergillus fumigatus. This condition commonly affects individuals with asthma or cystic fibrosis, leading to inflammation and damage to the bronchial tubes. The use of antifungal agents is warranted because they directly target the fungal organisms responsible for the colonization. By reducing the fungal load in the lungs, antifungal medications can help alleviate the symptoms associated with ABPA, decrease inflammation, and improve the patient’s lung function. While antibiotics may be useful in treating bacterial infections, they do not have a role in managing fungal infections like ABPA. Bronchodilators may help relieve wheezing and airway obstruction, but they do not address the underlying fungal colonization. Calcium channel blockers are used for other conditions, such as hypertension or certain types of arrhythmias, and have no relevance in the management of ABPA. Therefore, the administration of antifungal agents is crucial in managing allergic bronchopulmonary aspergillosis by targeting the underlying fungal component of the disease, making this the appropriate choice in the context of reducing fungal colonization.