156b - Biliary Tract Disorders Flashcards
Which serum liver chemistry test is specific for bile duct damage?
Alk-phos
Which serum liver chemistry tests indicate hepatocyte death?
ALT and AST
- Stored in hepatocyte cytosol
- Released when they die
List 3 significant lab findings in primary biliary cholangitis
- Elevated Alk-phos
- Elevated GGT
- (+) AMA
Which part of the liver will be most inflamed in primary biliary cholangitis?
Around the portal triad
(small ducts are obstructed)
When does UDP-GT activty begin in the newborn?
5 days after birth (regardless of gestational age)
- UGP-GT conjugates bilirubin
- May see some jaundice before UDP-GT activity starts
- Can use UV light to metabolize
Which genetic mutation is most likely in people with intermittent jaundice (when sick) and no other symptoms?
What lab findings will be significant?
Mutation in the promoter region of the UDP-GT gene
-> Gilbert’s Disease
(Extra TA in the TATA box)
Decreased UDP-GT transcription
-> mild unconjugated hyperbilirubinemia
What is the most likely cause of the patient’s symptoms?
Alcoholic liver disease
- AST > ALT with both elevated => Alcoholic liver disease
What mutation is associated with intrahepatic cholesasis of pregnacy?
What is the treatment?
Abcb4 (aka MDR3)
Treat with ursodeoxycholic acid
- Increases hydrophilicity of bile pool
- Stimulates bile flow
- Helps symptoms
- Decreased pruitis, LFTs
- Better fetal outcomes