American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of medications can assist in managing itchy skin associated with liver diseases?

1. H2 blockers

2. Antidepressants

3. Antihistamines

4. Antibiotics

The correct answer is: Antihistamines

Antihistamines are particularly effective in managing pruritus (itchy skin) associated with liver diseases due to their ability to block histamine receptors, which play a role in the body's allergic response and can contribute to the sensation of itchiness. In liver disease, it is common for patients to experience cholestasis, where bile acids accumulate in the bloodstream, leading to intense itching. Antihistamines can alleviate this itching by reducing the stimulating effects of histamines on the skin and central nervous system. Other types of medications listed are less effective in addressing this specific symptom. H2 blockers primarily reduce stomach acid and are not indicated for pruritus; antidepressants have been explored for their potential analgesic and ant itch properties but are not first-line treatments for itch resulting from liver disease; antibiotics are used to treat infections and do not help alleviate itch directly. Thus, antihistamines stand out as the most appropriate choice for managing itchy skin in patients with liver conditions.