156b - Biliary Tract Disorders Flashcards

1
Q

Which serum liver chemistry test is specific for bile duct damage?

A

Alk-phos

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2
Q

Which serum liver chemistry tests indicate hepatocyte death?

A

ALT and AST

  • Stored in hepatocyte cytosol
  • Released when they die
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3
Q

List 3 significant lab findings in primary biliary cholangitis

A
  • Elevated Alk-phos
  • Elevated GGT
  • (+) AMA
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4
Q

Which part of the liver will be most inflamed in primary biliary cholangitis?

A

Around the portal triad

(small ducts are obstructed)

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5
Q

When does UDP-GT activty begin in the newborn?

A

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
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6
Q

Which genetic mutation is most likely in people with intermittent jaundice (when sick) and no other symptoms?

What lab findings will be significant?

A

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

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7
Q

What is the most likely cause of the patient’s symptoms?

A

Alcoholic liver disease

  • AST > ALT with both elevated => Alcoholic liver disease
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8
Q

What mutation is associated with intrahepatic cholesasis of pregnacy?

What is the treatment?

A

Abcb4 (aka MDR3)

Treat with ursodeoxycholic acid

  • Increases hydrophilicity of bile pool
  • Stimulates bile flow
  • Helps symptoms
    • Decreased pruitis, LFTs
    • Better fetal outcomes
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