Sketchy Path: Autoimmune Biliary Tract Disorders and Cancer Flashcards
Primary biliary cholangitis is autoimmune-mediated destrcution of _________ bile duct
INTRAhepatic
What is used to confirm the diagnosis of primary biliary cholangitis
Anti-mitochondrial AB
What other diseases do pts with Primary Biliary Cholangitis have?
other autoimmune disease (Sjogrens etc)
What is seen in the portal triad of pts with Primary Biliary Cholangitis?
Granulomas
What skin findings can you see with Primary Biliary Colangitis?
Hyperpigmentation
Xanthomas (eyelids)
Pruritus
Jaundice (late finding)
Progression of PBC leads to what?
Cirrhosis
What vitamins can be deficient in those with bile stasis?
A D E K Fat soluble Vitamins
What can be used in the treatment of primary biliary cirrhosis?
Ursodiol
Increases the excretion of bile and increases cholesterol reabsoprtion
(ursodeoxycholic acid)
What are the two major differences between PSC and PBC?
PSC is MALE dominant
PSC is a disease of BOtH intra and extra hepatic biliary tree
PSC has a strong assc with what antigens?
HLA-DR (MHC II)
PSC is assc with ab?
p-ANCA
Ulcerative Colitis patietns can classically get what biliary disorder?
UC
“PSC goes with UC”
What appearance does the biliary tree have in PSC?
Beading due to alternating sclerosis
Which autoimmune biliary disorder can present with ascending cholangitis?
PSC
charcot triad
What cancers can PSC lead to ?
Hepatocellular Carcinoma
Cholangiocarcinoma
What is your diagnosis of a young child presenting with jaundice, RUQ pain, and RUQ mass?
Choledochal Cyst
Why are most choledochal cyst taken out?
Raise risk of cholangiocarcinoma
In east asia what is an important risk factor for cholangiocarcinoma?
Clonorchis sinensis
Liver Fluke
Obstruction of the biliary tree by cholangiocarcinoma can lead to what two findings?
Dark Urine
Pale stool
What is courvoisier sign?
Non tender palpable gallbladder and jaundice common in cholangiocarcinoma
