Gastroenterology: autoimmune pancreatitis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: autoimmune pancreatitis

Sample item

A 60-year-old man has obstructive jaundice, a diffusely enlarged sausage-shaped pancreas, serum IgG4 elevated and a mass-free biliary stricture. What is the treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Oral corticosteroids

Type 1 autoimmune pancreatitis is an IgG4-related disease and responds dramatically to glucocorticoids. Diagnostic features include diffuse pancreatic enlargement, high IgG4 and lymphoplasmacytic infiltrate. Steroid response helps to separate it from pancreatic cancer.

Option by option

  • A. Oral corticosteroids (correct)

    Correct. Steroids are first-line.

  • B. ERCP stenting only

    Stenting alone does not treat the underlying inflammation.

  • C. Gemcitabine chemotherapy

    Chemotherapy is for adenocarcinoma.

  • D. Whipple procedure

    Surgery is for cancer, not IgG4-related disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Oral corticosteroids. Type 1 autoimmune pancreatitis is an IgG4-related disease and responds dramatically to glucocorticoids.

Why is "ERCP stenting only" not the answer?

Stenting alone does not treat the underlying inflammation.

Why is "Gemcitabine chemotherapy" not the answer?

Chemotherapy is for adenocarcinoma.

Why is "Whipple procedure" not the answer?

Surgery is for cancer, not IgG4-related disease.

What concept does this question test?

It tests Gastroenterology: autoimmune pancreatitis in General Medicine. Diagnostic features include diffuse pancreatic enlargement, high IgG4 and lymphoplasmacytic infiltrate. Steroid response helps to separate it from pancreatic cancer.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: autoimmune pancreatitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.