Papulosquamous disorders: cholestatic pruritus: practice question

A Dermatology 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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Dermatology · Papulosquamous disorders: cholestatic pruritus

Sample item

A woman with primary biliary cholangitis has severe generalised itching without rash. Which drug is first-line for the pruritus?

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

The answer and the reasoning

C. Cholestyramine

In cholestatic pruritus, the bile acid sequestrant cholestyramine is first line. Rifampicin, naltrexone and sertraline are successive options. Antihistamines are generally ineffective because histamine is not the main mediator.

Option by option

  • A. Cetirizine

    Antihistamines are poorly effective in cholestatic itch.

  • B. Prednisolone

    Steroids do not relieve cholestatic itch and harm bone.

  • C. Cholestyramine (correct)

    Correct. Cholestyramine is the first-line drug.

  • D. Methotrexate

    Methotrexate is not used for pruritus.

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.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Cholestyramine. In cholestatic pruritus, the bile acid sequestrant cholestyramine is first line.

Why is "Cetirizine" not the answer?

Antihistamines are poorly effective in cholestatic itch.

Why is "Prednisolone" not the answer?

Steroids do not relieve cholestatic itch and harm bone.

Why is "Methotrexate" not the answer?

Methotrexate is not used for pruritus.

What concept does this question test?

It tests Papulosquamous disorders: cholestatic pruritus in Dermatology. Rifampicin, naltrexone and sertraline are successive options. Antihistamines are generally ineffective because histamine is not the main mediator.

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 Papulosquamous disorders: cholestatic pruritus?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.