American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common treatment for pruritus associated with primary biliary cholangitis?

1. Cholestyramine

2. Antidepressants

3. Glucocorticoids

4. Topical corticosteroids

The correct answer is: Cholestyramine

Cholestyramine is commonly used to alleviate pruritus associated with primary biliary cholangitis (PBC) due to its ability to bind bile acids in the intestine. In PBC, the liver's ability to excrete bile acids is impaired, leading to their accumulation in the bloodstream, which can cause itching. By binding these bile acids, cholestyramine reduces their circulation in the body, thereby helping to relieve the associated itching. Other treatment options like antidepressants, glucocorticoids, and topical corticosteroids may play roles in managing symptoms or associated conditions but are not typically considered first-line treatments specifically for the pruritus caused by primary biliary cholangitis. Antidepressants may help in managing the emotional effects of chronic itching, glucocorticoids can suppress inflammation in various conditions, and topical corticosteroids could provide localized relief for certain skin conditions, but cholestyramine is the preferred choice for addressing the underlying cause related to bile acid accumulation.