A 32-year-old woman with ulcerative colitis presents with severe bloody diarrhea (15 stools/day) and cramping abdominal pain. Vital signs show temperature 38.5°C, heart rate 110 bpm, blood pressure 102/68 mmHg, and respiratory rate 18/min. Laboratory findings reveal hemoglobin 8.2 g/dL, albumin 2.8 g/dL, and C-reactive protein 12.5 mg/dL. Colonoscopy demonstrates continuous mucosal ulceration from rectum to splenic flexure. She reports no recent antibiotic use. Which pharmacologic agent is most appropriate for initiating therapy?
- A)Oral prednisone 40 mg daily
- B)IV methylprednisolone 500 mg dailyGABARITO
- C)Ciprofloxacin 500 mg daily
- D)Azathioprine 1-2 mg/kg daily
- E)Infliximab 5 mg/kg IV
Explicação
This patient has severe acute ulcerative colitis with signs of systemic compromise (anemia, hypoalbuminemia, tachycardia). First-line treatment is IV corticosteroids (IV methylprednisolone 500 mg daily or IV hydrocortisone 300 mg daily). If no improvement in 3... Ver explicação completa e trilha adaptativa →