American Board of Internal Medicine (ABIM) Certification Practice Exam

Which side effect is associated with higher doses of glucocorticoids in treating ulcerative colitis?

1. Increased efficacy

2. More side effects

3. Less frequency of administration

4. Reduced risk of infection

The correct answer is: More side effects

Higher doses of glucocorticoids in the treatment of ulcerative colitis are associated with more side effects due to the pharmacological action of these steroids in the body. Glucocorticoids, such as prednisone, are commonly used to reduce inflammation and suppress the immune response in conditions like ulcerative colitis. However, as the dosage increases, so does the likelihood and severity of potential side effects. Common side effects from elevated doses may include weight gain, hypertension, hyperglycemia, osteoporosis, mood changes, and increased susceptibility to infections. The immunosuppressive nature of glucocorticoids can lead to a higher risk of opportunistic infections, especially when used in high doses over extended periods. The other options do not accurately reflect the relationship between dosage and side effects. Increased efficacy may be noted, but it is overshadowed by the risk of adverse effects at higher doses. There is also no improvement in the frequency of administration with higher doses; rather, the opposite is true as increased doses may require careful monitoring and adjusted dosing schedules. Finally, the risk of infection does not decrease with higher doses of glucocorticoids; in fact, the contrary is true, as the immune system becomes more suppressed. Thus, the