psc and pbc Flashcards
what is primary sclerosing cholingitis?
inflammation and scarring of the intra and extrahepatic bile ducts?
male to female ratio of PSC?
2:1
at what age does PSC mostly happen?
30-40
what is the psc triad?
immune mediated (not autoimmune), genetic predisposition, disruption of biliary epithelium from bacterial translocation
what disease is PSC it associated with?
ulcerative coliitis
what is the biliary epithelium?
epithelium that lines the biliary ducts
what is the pathophysiology of psc?
bacterial infection from gut -> inflammation of biliary epithelium -> bile acid leakage -> scarring of hepatocyte and inflammation of the biliary epithelium -> even more cholestasis -> goes on
complications of PSC?
- cholangiocarcinoma
- hepatocellular carcinoma
- gallbladder malignancy
- pancreatic cancer
- colorectal cancer
what is the chemical marker for PSC diagnosis?
increased ALP levels (20-140 IU/L)
what are the autoantibodies present in PSC?
antismoothmuscles, antinuclear, anti nuclear cytoplasmic antibodies
what is the imaging used in PSC?
magnetic resonance cholangiopancreatic imaging
what is the primary biliary cholingiatis?
autoimmune condition related to destrution of small bile ducts
which gender is PBC most prevalent?
female (9:1)
what syndromes associate with PBC
sjorgen’s and celiac syndrome, thyroiditis
which age is PBC most prevalent?
50
what antibodies are present in PBC?
antimitochondrial antibodies
what is the histological evidence for PBC?
non suppurative chronic biliary duct obstruction
what medicine is used to relief pruritis?
cholestyramine
what does ursodeoxycholic acid do?
decreases toxicity to biliary epithelium
what does obeticholic acid do?
decreases bile acid synthesis and consequently inflammation
what is the superiormost structure of the biliary tree
the right and left hepatic duct that binds to become the common hepatic duct
what is the duct that comes out from the gallbladder?
the cystic duct
what comes after the cystic and common hepatic duct?
the combination to become the common bile duct
what does common bile duct connect with?
the pancreatic duct
what is the end of the biliary tree?
the hepatopancreatic ampulla of Vater
