American Board of Internal Medicine (ABIM) Certification Practice Exam

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Frequent ophthalmologic examinations are recommended for patients taking which medication for multiple sclerosis due to the risk of macular edema?

Interferon beta
Fingolimod
Rituximab
Glatiramer acetate

The correct answer is: Fingolimod

Fingolimod is associated with the risk of developing macular edema, particularly in patients with a history of uveitis, and this warrants the recommendation for frequent ophthalmologic examinations. The mechanism behind this side effect appears to involve alterations in retinal vascular permeability, leading to fluid accumulation in the macula. Regular eye evaluations can help in the early detection and management of macular edema, which is crucial given the potential impact on vision. While the other medications listed may have their own side effects and require monitoring, they are not specifically linked to macular edema in the same manner as fingolimod. Therefore, the need for regular ophthalmologic assessment is a focused precaution uniquely relevant to patients on fingolimod therapy for multiple sclerosis.