Inflammatory bowel disease (ulcerative colitis) Quiz: Ace Your Exams

A 52-year-old woman presents to the primary care clinic because of a 3-month history of bloody diarrhea, crampy abdominal pain, and tenesmus. Her symptoms have been progressing and she has been having 5 episodes of loose bloody stool per day for the past month. Past medical history is significant for type 2 diabetes mellitus. Temperature is 37.3 °C (99.1 °F), blood pressure is 142/85, pulse is 92/min, and respiratory rate is 18/min. The patient appears comfortable. Physical examination is significant for moderate abdominal tenderness on palpation and bright red blood on digital rectal exam. Laboratory findings are significant for a hemoglobin of 10.3 g/dL and an elevated CRP. Stool studies are negative for infectious etiologies. Fecal calprotectin is positive. A colonoscopy reveals a continuous pattern of erythema, friability, and ulcerations in the rectum and sigmoid colon. Histopathological examination reveals mucosal and submucosal chronic inflammation, and crypt abscesses consistent with the diagnosis of ulcerative colitis. Which of the following medications should be administered to induce remission in this patient?