Biliary tract disease

Question 1

Types

Answer 1

1) secondary biliary cirrhosis
2) primary biliary cirrhosis
3) primary sclerosing cholangitis

Question 2

Secondary biliary cirrhosis:

Pathophys

Answer 2

extrahepatic obstruction, chronic hepatitis, pancreatic carcinoma
leading to increased pressure in intrahepatic ducts,
injury/fibrosis and bile stasis

Question 3

Secondary biliary cirrhosis:

Presentation

Answer 3

Pruritis,
jaundice
dark urine,
light stool
HSM

Question 4

Secondary biliary cirrhosis:

lab

Answer 4

increased conjugated bili
increased cholesterol
increase alk phos

Question 5

secondary biliary cirrhosis:

complication

Answer 5

complicated by ascending chonagitis

Question 6

Primary biliary cirrhosis:

pathophys

Answer 6

Autoimmune -> lymphocytic infiltrates

+ granulomas

Question 7

Primary biliary cirrhosis:

additional

Answer 7

Increased serum mitochondrial antibodies (including IgM)

Associated with other autoimmune (CREST, RA, celiac disease)

Question 8

Primary sclerosing cholangitis:

pathophys

Answer 8

Unknown cuase
Onion skinning fibrosis
Beads in a string

Question 9

Primary sclerosing cholangitis:

additional

Answer 9

Hypergammaglobinemia (IgM)
Associated with UC
Can lead to 2nd biliary cirrhosis