American Board of Internal Medicine (ABIM) Certification Practice Exam

Which drug withdrawal may help in the treatment of microscopic colitis?

1. Sertraline

2. Metformin

3. Amiodarone

4. Dabigatran

The correct answer is: Sertraline

Microscopic colitis is a condition characterized by inflammation of the colon that often presents with chronic, watery diarrhea. Treatment typically involves addressing underlying causes or triggers that could be contributing to the condition. Among the options given, sertraline, which is a selective serotonin reuptake inhibitor (SSRI) used primarily to treat depression and anxiety, has been associated with cases of microscopic colitis. In some patients, the discontinuation of sertraline has led to improvement in colitis symptoms, suggesting that the drug might have a role in exacerbating the condition. Thus, withdrawing sertraline can alleviate gastrointestinal symptoms in certain individuals suffering from microscopic colitis. This link highlights the importance of considering medication history and potential drug reactions when treating patients with gastrointestinal complaints. The other medications listed do not have a recognized association with microscopic colitis or do not typically require withdrawal to manage this condition. Metformin is an antidiabetic medication that is not known to cause or exacerbate microscopic colitis. Amiodarone is primarily used for cardiac arrhythmias and doesn’t have a direct link to microscopic colitis exacerbation. Dabigatran, an anticoagulant, also does not have documented effects on microscopic colitis. Therefore, the withdrawal of ser