Immunology: anti-mitochondrial antibody: practice question

A Microbiology 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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Microbiology · Immunology: anti-mitochondrial antibody

Sample item

A 48-year-old woman has generalised itching and fatigue for months. Her alkaline phosphatase is markedly raised with a mildly raised bilirubin, and ultrasound shows no bile duct obstruction. Which autoantibody is most likely to be found?

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

The answer and the reasoning

C. Anti-mitochondrial antibody

Primary biliary cholangitis presents in middle-aged women with pruritus and a cholestatic enzyme pattern, and anti-mitochondrial antibody directed against the pyruvate dehydrogenase complex is found in the large majority. Autoimmune hepatitis shows anti-smooth muscle and anti-LKM antibodies with a hepatitic enzyme pattern.

Option by option

  • A. Anti-liver kidney microsomal antibody

    Anti-LKM1 antibody is found in type 2 autoimmune hepatitis, mainly in children.

  • B. Anti-thyroid peroxidase antibody

    Anti-thyroid peroxidase antibody indicates autoimmune thyroiditis and may accompany but does not define this picture.

  • C. Anti-mitochondrial antibody (correct)

    Correct. Anti-mitochondrial antibody is the serological hallmark of primary biliary cholangitis.

  • D. Anti-smooth muscle antibody

    Anti-smooth muscle antibody points to type 1 autoimmune hepatitis, usually with raised transaminases.

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 Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Anti-mitochondrial antibody. Primary biliary cholangitis presents in middle-aged women with pruritus and a cholestatic enzyme pattern, and anti-mitochondrial antibody directed against the pyruvate dehydrogenase complex is found in the large majority.

Why is "Anti-liver kidney microsomal antibody" not the answer?

Anti-LKM1 antibody is found in type 2 autoimmune hepatitis, mainly in children.

Why is "Anti-thyroid peroxidase antibody" not the answer?

Anti-thyroid peroxidase antibody indicates autoimmune thyroiditis and may accompany but does not define this picture.

Why is "Anti-smooth muscle antibody" not the answer?

Anti-smooth muscle antibody points to type 1 autoimmune hepatitis, usually with raised transaminases.

What concept does this question test?

It tests Immunology: anti-mitochondrial antibody in Microbiology. Autoimmune hepatitis shows anti-smooth muscle and anti-LKM antibodies with a hepatitic enzyme pattern.

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 Immunology: anti-mitochondrial antibody?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.