Autoantibodies

Question 1

Anti-smooth muscle antibody

Answer 1

autoimmune hepatitis

Question 2

LKSM - Liver kidney microsomal type 1 antibody

Answer 2

autoimmune hepatitis

Question 3

Anti mitochondrial antibodies

Answer 3

PBC

Question 4

Anti-transglutaminase Antibodies

Answer 4

celiac, T1DM, IBD

Question 5

Anti-endomysial

Answer 5

celiac disease

Question 6

Anti-epidermal transglutaminase

Answer 6

celiac, thought to cause dermatitis herpetiformis

Question 7

Anti-gliadin antibodies

Answer 7

Anti-gliadin IgA- celiac disease Anti–gliadine Ig G - celiac disease Anti-gliadine IgE - allergy related conditions - urticaria, asthma

Question 8

Caeruloplasmin

Answer 8

low in Wilson’s disease

Question 9

Faecal calpronectin

Answer 9

gut inflammation/meutrophils, seen in colorectal ca, IBD, coeliac, infectious colitis. Normal in IBS

Question 10

+ ASCA and –ve ANCA

Answer 10

suggestive of Crohns

Question 11

-ve ASCA and +ve ANCA

Answer 11

suggestive of UC

Question 12

Biopsy -Fatty liver disease

Answer 12

usually affects the pericentral (zone 3) region first, extending along sinusoids and around individual hepatocytes in a ‘chicken-wire’ pattern

Question 13

Biopsy - -NASH - steatohepatitis

Answer 13

Usually more lobular than portal presence of steatosis, ballooning and lobular inflammation (with or without fibrosis) Mallory-Denk bodies

Question 14

Biopsy - Acute Hepatitis

Answer 14

lobular pattern of inflammation mild with minor infiltrates and spotty necrosis of single hepatocytes, or in severe cases cause widespread necrosis with architectural disturbance (lobular disarray) or collapse

Question 15

Biopsy - AIH

Answer 15

plasma cell–rich infiltrate and positive immunology clustering of regenerating hepatocytes in areas of fibrous portal expansion is called a ‘rosette

Question 16

Biopsy - PBC

Answer 16

portal inflammatory infiltrate with a granulomatous component centered on small bile ducts associated with injury to the biliary epithelial cells and disruption of the bile duct basement membrane. Small bile ducts are progressively lost (ductopenia).Periportal fibrosis then ensues and can progress to cirrhosis.

Question 17

Biopsy - PSC

Answer 17

Fibrous obliteration of bile ducts can occur; the classical lesion is a concentric ‘onion skin’ fibrosis around an affected duct Granulomas not typically seen

Question 18

ETOH Hepatitis Biopsy -

Answer 18

Mallory Hyaline