Hepatobiliary and pancreatic surgery: autoimmune pancreatitis: practice question

A General Surgery 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 Surgery · Hepatobiliary and pancreatic surgery: autoimmune pancreatitis

Sample item

A 60-year-old man has obstructive jaundice, weight loss and diffuse sausage-shaped pancreatic enlargement on CT with a featureless duct. Serum IgG4 is raised, and cholangiography shows multiple bile duct strictures. Which treatment is most appropriate?

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 that mimics pancreatic cancer. Diffuse enlargement, raised IgG4 and multiple strictures point to it, and it responds dramatically to corticosteroids. Biopsy or a trial of steroids helps avoid unnecessary resection.

Option by option

  • A. Oral corticosteroids (correct)

    Correct. A brisk response to steroids is characteristic and often confirms the diagnosis.

  • B. Gemcitabine chemotherapy

    Chemotherapy treats pancreatic adenocarcinoma, which is not the diagnosis.

  • C. Endoscopic stenting alone

    Stenting relieves jaundice transiently but does not treat the inflammatory process.

  • D. Pancreaticoduodenectomy

    Resection is for confirmed malignancy and would be unnecessary here.

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 Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Oral corticosteroids. Type 1 autoimmune pancreatitis is an IgG4-related disease that mimics pancreatic cancer.

Why is "Gemcitabine chemotherapy" not the answer?

Chemotherapy treats pancreatic adenocarcinoma, which is not the diagnosis.

Why is "Endoscopic stenting alone" not the answer?

Stenting relieves jaundice transiently but does not treat the inflammatory process.

Why is "Pancreaticoduodenectomy" not the answer?

Resection is for confirmed malignancy and would be unnecessary here.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: autoimmune pancreatitis in General Surgery. Diffuse enlargement, raised IgG4 and multiple strictures point to it, and it responds dramatically to corticosteroids. Biopsy or a trial of steroids helps avoid unnecessary resection.

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 Hepatobiliary and pancreatic surgery: autoimmune pancreatitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.