Sketchy Path: Autoimmune Biliary Tract Disorders and Cancer Flashcards

1
Q

Primary biliary cholangitis is autoimmune-mediated destrcution of _________ bile duct

A

INTRAhepatic

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2
Q

What is used to confirm the diagnosis of primary biliary cholangitis

A

Anti-mitochondrial AB

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3
Q

What other diseases do pts with Primary Biliary Cholangitis have?

A

other autoimmune disease (Sjogrens etc)

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4
Q

What is seen in the portal triad of pts with Primary Biliary Cholangitis?

A

Granulomas

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5
Q

What skin findings can you see with Primary Biliary Colangitis?

A

Hyperpigmentation
Xanthomas (eyelids)
Pruritus
Jaundice (late finding)

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6
Q

Progression of PBC leads to what?

A

Cirrhosis

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7
Q

What vitamins can be deficient in those with bile stasis?

A
A
D
E
K
Fat soluble Vitamins
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8
Q

What can be used in the treatment of primary biliary cirrhosis?

A

Ursodiol
Increases the excretion of bile and increases cholesterol reabsoprtion
(ursodeoxycholic acid)

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9
Q

What are the two major differences between PSC and PBC?

A

PSC is MALE dominant

PSC is a disease of BOtH intra and extra hepatic biliary tree

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10
Q

PSC has a strong assc with what antigens?

A

HLA-DR (MHC II)

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11
Q

PSC is assc with ab?

A

p-ANCA

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12
Q

Ulcerative Colitis patietns can classically get what biliary disorder?

A

UC

“PSC goes with UC”

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13
Q

What appearance does the biliary tree have in PSC?

A

Beading due to alternating sclerosis

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14
Q

Which autoimmune biliary disorder can present with ascending cholangitis?

A

PSC

charcot triad

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15
Q

What cancers can PSC lead to ?

A

Hepatocellular Carcinoma

Cholangiocarcinoma

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16
Q

What is your diagnosis of a young child presenting with jaundice, RUQ pain, and RUQ mass?

A

Choledochal Cyst

17
Q

Why are most choledochal cyst taken out?

A

Raise risk of cholangiocarcinoma

18
Q

In east asia what is an important risk factor for cholangiocarcinoma?

A

Clonorchis sinensis

Liver Fluke

19
Q

Obstruction of the biliary tree by cholangiocarcinoma can lead to what two findings?

A

Dark Urine

Pale stool

20
Q

What is courvoisier sign?

A

Non tender palpable gallbladder and jaundice common in cholangiocarcinoma