52-year-old Woman in Medicine / Internal Medicine — 52yo Woman | Hepatology | SMLE Q#11877
SMLE Question #11877
Medicine / Internal Medicine
Hepatology
Objective: OBJ-HEP-01
Last updated: February 2026
A 52-year-old woman has 4 months of progressive generalized pruritus, fatigue, and scleral icterus. Examination shows mild hepatomegaly without ascites. Liver tests show a predominantly cholestatic pattern. Abdominal ultrasound shows hepatomegaly without biliary duct dilatation. Viral hepatitis serology is negative, and autoantibodies show high-titre ANA and positive antimitochondrial antibody. What is the most appropriate initial pharmacologic management to slow disease progression and improve cholestasis?
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