Gastroenterology Education and CPD for trainees and specialists

1. Which one of the following statements regarding Autoimmune hepatitis (AIH) is true?

1. An acute onset of illness is common (40%)- TRUE
2. Women are affected more than men (M: F- 1:2)
3. Predominant serum alkaline phosphatase abnormality
4. Immunoglobulin level is usually normal
5. Splenomegaly and spider naevi never occurs in absence of cirrhosis

2. Which one of the following statements regarding Autoimmune hepatitis (AIH) is true?

1. Auto antibodies at least in 1:80 titres in adults- ANA, SMA or LKM1 and no AMA
2. Bilirubin >4fold increase is unusual
3. Anti-LKM1 typically occurs in the absence of SMA and ANA
4. Bridging necrosis is an indication of treatment
5. All above

3. Which one of the following statements regarding Autoimmune hepatitis (AIH) is false?

1. Both steroid only and steroid and azathioprine are approved treatment options
2. Adults rarely achieve remission in less than 12 months
3. Histologic improvement lags behind clinical and laboratory improvement by 3 to 6 months
4. Sixty-five percent of patients enter remission within 18 months
5. Biochemical remission is defined as serum aminotransferase to normal- FALSE

4. Which one of the following statements regarding Autoimmune hepatitis (AIH) is false?

1. Relapse is characterized by an increase in the serum aminotransferase level to more than 3-fold the upper limit of normal and/or increase in the serum gamma-globulin level to more than 2 g/dL
2. Indefinte low dose treatment is given after second relapse
3. Relapse occurs in from 20% to 100% of patients who enter remission.
4. After first relapse long term treatment is needed- FALSE
5. Biochemical remission means serum aminotransferase levels to less than twice normal, restoration of serum bilirubin and gammaglobulin levels to normal

5. Which one of the following statements regarding Autoimmune hepatitis (AIH) is false?

1. The treatment is continued is until remission, treatment failure, incomplete response, or drug toxicity occurs
2. Histologic improvement lags behind clinical and laboratory improvement by 3 to 6 months
3. 13% will have incomplete response
4. 20% will have treatment failure- FALSE
5. Treatment failure group should be started on high dose regimen.

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MCQ On Autoimmune hepatitis

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