skip to main content

Primary Biliary Cholangitis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyGastroenterologyPrimary Biliary CholangitisRACP Adult Medicine

A 48-year-old woman presents with fatigue, pruritus, and elevated ALP (450 U/L). Anti-mitochondrial antibody (AMA) is positive. Liver biopsy shows florid duct lesion with granulomatous destruction of interlobular bile ducts. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Primary biliary cholangitis

Positive AMA with elevated ALP, pruritus, and granulomatous bile duct destruction on biopsy is diagnostic of primary biliary cholangitis (PBC). First-line treatment is ursodeoxycholic acid (UDCA). Obeticholic acid or fibrates may be added if response to UDCA is inadequate.

Reference: EASL – 2022 – PBC Guidelines; eTG Gastrointestinal 2024