Cholangitis

Question 1

What is the pathophysiology in PBC?

Answer 1

Interlobular bile ducts are damaged by chronic autoimmune granulomatous inflammation causing cholestasis

Question 2

What is the female to male ratio?

Answer 2

9:1

Question 3

What are some risk factors for PBC?

Answer 3

Positive family history, many UTIs, smoking, other autoimmune conditions, lots of nail polish/hair dye use

Question 4

What is results would you expect from FBC, LFT and CRP in cholangitis?

Answer 4

Leucocytosis, raised ALP, raised bilirubin, raised CRP

Question 5

What in Charcot’s triad is present in cholangitis?

Answer 5

RUQ pain, fever/WCC and jaundice

Question 6

What is PSC?

Answer 6

Progressive cholestasis with bile duct inflammation and strictures, affects ducts inside and outside the liver

Question 7

In which type of cholangitis is AMA present?

Answer 7

PBC

Question 8

What is ERCP?

Answer 8

Endoscopic retrograde cholangiopancreatography

Question 9

What is MRCP?

Answer 9

Magnetic resonance cholangiopancreatography

Question 10

What investigations would you do to find out which antibiotics to use?

Answer 10

Blood cultures, MC&S

Question 11

How would you manage cholangitits?

Answer 11

Treat sepsis, ERCP and stent to mechanically clear the blockage, cholecystectomy if necessary

Question 12

What is Charcot’s triad?

Answer 12

Jaundice, RUQ pain, fever with rigors