Primary Biliary Cirrhosis Flashcards
1
Q
What are some clinical clues to PBC on examination
A
Female - 75-90%
Pigmentation - due to melanin deposition
Evidence of anaemia
- increased risk of peptic ulcer disease in PBC
- Also increasd risk of oesophaegeal varacies
- Also due to other autoimmune disease e.g, coeliac
Xanthalesma - in 10% - often late in the disease
Tendon xanthoma are uncommon (both due to hypercholesterolaemia)
Hepatomegaly in 70%
Splenomegaly - late disease - indicate portal hypertension
Pruritis - evidence of excoriation
Evidence of other autoimmune disease Graves - goitre Sjogrens (seen in 80% PBC) - dry eyes/mouth - RA - polyarthropathy Scleroderma - telangiectasia Dermatomyositis - heliotrop rash/gottrons papules Myasthenia gravis Vitiligo
Malabsorption of fat soluble vitamins
Coagulopathy - (Vit K)
Osteoporosis/osteopaenia or proximal myopathy- Vit D (may have scoliosis or proximal myopathy)
Jaundice is a late feature
Hepatic bruit would indicate malignancy
2
Q
What are some drug causes of cholestasis
A
Phenothiazines Sulphonamides Penicillins Rifampicin Macrolides Carbemazapine Synthetic steroids Diclofenac
