psc and pbc

Question 1

what is primary sclerosing cholingitis?

Answer 1

inflammation and scarring of the intra and extrahepatic bile ducts?

Question 2

male to female ratio of PSC?

Answer 2

2:1

Question 3

at what age does PSC mostly happen?

Answer 3

30-40

Question 4

what is the psc triad?

Answer 4

immune mediated (not autoimmune), genetic predisposition, disruption of biliary epithelium from bacterial translocation

Question 5

what disease is PSC it associated with?

Answer 5

ulcerative coliitis

Question 6

what is the biliary epithelium?

Answer 6

epithelium that lines the biliary ducts

Question 7

what is the pathophysiology of psc?

Answer 7

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

Question 8

complications of PSC?

Answer 8

1. cholangiocarcinoma
2. hepatocellular carcinoma
3. gallbladder malignancy
4. pancreatic cancer
5. colorectal cancer

Question 9

what is the chemical marker for PSC diagnosis?

Answer 9

increased ALP levels (20-140 IU/L)

Question 10

what are the autoantibodies present in PSC?

Answer 10

antismoothmuscles, antinuclear, anti nuclear cytoplasmic antibodies

Question 11

what is the imaging used in PSC?

Answer 11

magnetic resonance cholangiopancreatic imaging

Question 12

what is the primary biliary cholingiatis?

Answer 12

autoimmune condition related to destrution of small bile ducts

Question 13

which gender is PBC most prevalent?

Answer 13

female (9:1)

Question 14

what syndromes associate with PBC

Answer 14

sjorgen’s and celiac syndrome, thyroiditis

Question 15

which age is PBC most prevalent?

Answer 15

50

Question 16

what antibodies are present in PBC?

Answer 16

antimitochondrial antibodies

Question 17

what is the histological evidence for PBC?

Answer 17

non suppurative chronic biliary duct obstruction

Question 18

what medicine is used to relief pruritis?

Answer 18

cholestyramine

Question 19

what does ursodeoxycholic acid do?

Answer 19

decreases toxicity to biliary epithelium

Question 20

what does obeticholic acid do?

Answer 20

decreases bile acid synthesis and consequently inflammation

Question 21

what is the superiormost structure of the biliary tree

Answer 21

the right and left hepatic duct that binds to become the common hepatic duct

Question 22

what is the duct that comes out from the gallbladder?

Answer 22

the cystic duct

Question 23

what comes after the cystic and common hepatic duct?

Answer 23

the combination to become the common bile duct

Question 24

what does common bile duct connect with?

Answer 24

the pancreatic duct

Question 25

what is the end of the biliary tree?

Answer 25

the hepatopancreatic ampulla of Vater