3 Days Of Worsening in Medicine / Internal Medicine — 30yo Woman | Gastroenterology | SMLE Q#11912
SMLE Question #11912
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 30-year-old woman with a 5-year history of left-sided ulcerative colitis presents with 3 days of worsening symptoms with 7–8 episodes/day of bloody diarrhea and crampy lower abdominal pain. She also reports new bilateral knee pain and morning stiffness. She stopped oral mesalamine 2 months ago. She appears ill and dehydrated with diffuse lower abdominal tenderness without peritoneal signs. Stool culture and Clostridioides difficile testing are negative. After initial IV fluid resuscitation, what is the most appropriate next step in management?
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