Hepatobiliary and pancreatic surgery: primary biliary cholangitis: 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: primary biliary cholangitis

Sample item

A 48-year-old woman has fatigue, itching and a raised alkaline phosphatase. Ultrasound shows normal bile ducts and she is positive for antimitochondrial antibodies. Which treatment is first-line?

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

The answer and the reasoning

A. Ursodeoxycholic acid

Primary biliary cholangitis is an autoimmune destruction of small intrahepatic bile ducts, positive for antimitochondrial antibodies. Ursodeoxycholic acid slows progression, and liver transplantation is the option for end-stage disease. Imaging shows normal large ducts.

Option by option

  • A. Ursodeoxycholic acid (correct)

    Correct. Ursodeoxycholic acid improves biochemistry and slows disease progression.

  • B. Biliary stent placement

    Large ducts are normal, so stenting has no role.

  • C. Liver resection

    Resection does not treat a diffuse autoimmune ductal disease.

  • D. Prednisolone

    Steroids are not effective in primary biliary cholangitis and cause bone loss.

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, Ursodeoxycholic acid. Primary biliary cholangitis is an autoimmune destruction of small intrahepatic bile ducts, positive for antimitochondrial antibodies.

Why is "Biliary stent placement" not the answer?

Large ducts are normal, so stenting has no role.

Why is "Liver resection" not the answer?

Resection does not treat a diffuse autoimmune ductal disease.

Why is "Prednisolone" not the answer?

Steroids are not effective in primary biliary cholangitis and cause bone loss.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: primary biliary cholangitis in General Surgery. Ursodeoxycholic acid slows progression, and liver transplantation is the option for end-stage disease. Imaging shows normal large ducts.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: primary biliary cholangitis?

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.