American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the treatment recommended for severe alcoholic hepatitis?

1. Endoscopic therapy

2. Prednisolone

3. Surgery

4. Antibiotics

The correct answer is: Prednisolone

The recommended treatment for severe alcoholic hepatitis is prednisolone. This corticosteroid therapy has been shown to reduce mortality in patients with this condition, particularly those with severe manifestations characterized by high levels of bilirubin and other factors. The anti-inflammatory properties of prednisolone can help mitigate the systemic inflammatory response that often accompanies severe alcoholic hepatitis. In addition to its effectiveness, the use of prednisolone is based on clinical studies which indicate that it can lead to significant improvements in liver function, as well as overall survival rates in patients. The prescription of prednisolone is typically reserved for cases classified as severe alcoholic hepatitis, as patients meeting specific criteria are likelier to benefit from the treatment. Other options like endoscopic therapy and surgery are not relevant for treating alcoholic hepatitis. Antibiotics may be necessary if there is an infection, but they do not address the underlying inflammation associated with alcoholic hepatitis. Hence, prednisolone stands out as the most suitable and recommended treatment approach.