Inflammatory Bowel Disease USMLE Step 1 Practice Question
A 19-year-old man presents to the emergency department with a 3-day history of bloody diarrhea (12-15 stools/day), severe left lower abdominal cramping, and fever. He has no recent travel or antibiotic use. Vital signs: temperature 39.1°C, heart rate 118/min, blood pressure 92/58 mmHg, respiratory rate 20/min. Laboratory findings show hemoglobin 8.8 g/dL, albumin 2.9 g/dL, C-reactive protein 9.2 mg/dL, and negative stool cultures including C. difficile PCR. Colonoscopy reveals continuous friable mucosa with shallow ulcerations extending from the rectum to the mid-colon, with normal mucosa proximally. Which of the following is contraindicated in the management of his acute presentation?
Answer choices
- ALoperamideCorrect answer
- BIntravenous hydrocortisone
- CMesalamine suppositories
- DBroad-spectrum antibiotics
- EFluid and electrolyte replacement
- FInfliximab
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