primary biliary colangitis

Question 1

who is primary billiard colangitis usually seen in?

Answer 1

middle aged females

Question 2

aetiology

Answer 2

interlobular bile ducts become damaged by a chronic inflammatory process causing progressive cholestasis which may eventually progress to cirrhosis.

Question 3

associations

Answer 3

sjogren’s syndrome
rheumatoid arthiritis
systemic sclerosis
thyroid disease

Question 4

clinical feautures

Answer 4

cholestatic jaundice
hyperpigmentation over pressure points
RUQ pain
clubbing

Question 5

immunology

Answer 5

anti-microbial antibodies M2 subtypes are present in 98% of patients and are highly specific.
smooth muscle antibodies in 30% of patients.
raised serum IgM.

Question 6

imaging

Answer 6

required before diagnosis to exclude an extra hepatic biliary obstruction

Question 7

first-line management

Answer 7

ursodeoxycholic acid - slows disease progression and improves symptoms.

Question 8

over treatment options

Answer 8

pruritus
fat-soluble vitamin
liver transplantation

Question 9

complications

Answer 9

cirrhosis
portal hypertension
ascites
visceral haemorrhage