American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients treated with interferon beta for multiple sclerosis, serum aminotransferase monitoring is crucial for detecting which condition?

1. Liver cirrhosis

2. Autoimmune hepatitis

3. Pancreatitis

4. Hepatic steatosis

The correct answer is: Autoimmune hepatitis

Monitoring serum aminotransferase levels in patients receiving interferon beta for multiple sclerosis is crucial for detecting autoimmune hepatitis. Interferon beta is known to have the potential to induce or exacerbate autoimmune conditions, and autoimmune hepatitis can develop as a result of this treatment. Autoimmune hepatitis is characterized by high levels of serum aminotransferases, often significantly elevated, indicating liver inflammation. Regular monitoring helps in early detection of such elevations, which can prompt further evaluation and management, including the possibility of discontinuing the medication or initiating specific treatment for the condition. On the other hand, while the other conditions mentioned—such as liver cirrhosis, pancreatitis, and hepatic steatosis—also involve liver function and may, in some cases, show altered aminotransferase levels, they are not primarily associated with interferon beta therapy in the same way as autoimmune hepatitis. Cirrhosis typically develops from chronic liver damage over time and may not present acutely with elevated aminotransferases. Pancreatitis involves different enzymes (like lipase or amylase) for monitoring. Hepatic steatosis usually does not present with significant aminotransferase elevation and is instead assessed through imaging or liver biopsy. Thus, in this