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18-5 Flashcards

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1
Q

Autoimmune Hepatitis primarily affects?

A

Females

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2
Q

Which HLA’s are associated with Autoimmune Hepatitis?

A

DR3 - White
DR4 - Japanese
DRB1 - South Americans

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3
Q

Autoimmune Hepatitis involves an immune attack on hepatocytes. What cells make up the lymphocytic infiltrate in the liver?

A

CD4 and CD8 T cells

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4
Q

Which T cells activate B cells (autoantibodies) with Autoimmune Hepatitis?

A

CD4 T cells

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5
Q

A diagnosis of Autoimmune Hepatitis requires 4 things. What are they?

A
  1. Autoantibodies
  2. Increased serum IgG
  3. Exclusion of other etiologies
  4. Supportive Histo findings of the liver
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6
Q

A diagnosis of Autoimmune Hepatitis requires 4 things. What are they?

A
  1. Autoantibodies
  2. Increased serum IgG
  3. Exclusion of other etiologies
  4. Supportive Histo findings of the liver
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7
Q

There are 2 types of Autoimmune Hepatitis. Who is affected by each and what autoantibodies are common?

A

Type 1 - adults
= SMA and ANA
Type 2 - kids
= LKM-1 and ACL-1

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8
Q

There are 2 types of Autoimmune Hepatitis. Who is affected by each and what autoantibodies are common?

A

Type 1 - adults
= SMA and ANA
Type 2 - kids
= LKM-1 and ACL-1

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9
Q

What fluorescent staining pattern is seen with the ANA with Type 1 Autoimmune Hepatitis?

A

Homogenous or speckled

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10
Q

List the morphologic findings with Autoimmune Hepatitis

A
  • Clusters of plasma cells
  • Emperipolesis
  • Rosettes
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11
Q

List the morphologic findings with Autoimmune Hepatitis

A
  • Clusters of plasma cells
  • Emperipolesis
  • Rosettes
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12
Q

Emperipolesis

A
  • Seen with Autoimmune Hepatitis

= Lymphocytes and plasma cells in the cytoplasm of hepatocytes

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13
Q

Rosettes

A
  • Seen with Autoimmune Hepatitis

= Circular regenerative hepatocytes around a cannaliculus

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14
Q

Common progression of autoimmune liver diseases?

A

Cirrhosis

HCC

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15
Q

What treatment can cause remission for some Autoimmune Hepatitis patients?

A

Prednisone +/- Azathioprine

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16
Q

What are 2 Autoimmune Cholangiopathies?

A

Primary Biliary Cholangitis

Primary Sclerosing Cholangitis

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17
Q

Autoimmune Cholangiopathies are autoimmune disorders of?

A

Bile ducts

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18
Q

Primary Biliary Cholangitis

Study These Flashcards
A

Destruction of small intrahepatic bile ducts

19
Q

Destruction of small intrahepatic bile ducts

Study These Flashcards
A

Primary Biliary Cholangitis

20
Q

Who is often affected by Primary Biliary Cholangitis?

Study These Flashcards
A

Females around 50 with other autoimmune disorders

21
Q

What antibodies will be present with Primary Biliary Cholangitis?

Study These Flashcards
A

Antimitochondrial (AMA) targeted against E2 of PDC-E2

22
Q

AMA (+) targeted against E2 is seen with?

Study These Flashcards
A

Primary Biliary Cholangitis

23
Q

What morphologic finding will be seen with Primary Biliary Cholangitis?

Study These Flashcards
A

Florid duct lesion

= lymphocytic/granulomatous bile duct destruction

24
Q

Florid duct lesion

Study These Flashcards
A

Lymphocyte/granulomatous bile duct destruction

– seen with Primary Biliary Cholangitis

25
Symptoms of Primary Biliary Cholangitis?
- Jaundice, pruritus, fatigue - Xanthelasmas and hypercholesterolemia - Splenomegaly - Skin hyperpigmentation and steatorrhea - Vitamin D Def. Osteoporosis
26
Symptoms of Primary Biliary Cholangitis?
- Jaundice, pruritus, fatigue - Xanthelasmas and hypercholesterolemia - Splenomegaly - Skin hyperpigmentatioon and steatorrhea - Vitamin D Def. Osteoporosis
27
Symptoms of Primary Biliary Cholangitis?
- Jaundice, pruritus, fatigue - Xanthelasmas and hypercholesterolemia - Splenomegaly - Skin hyperpigmentation and steatorrhea - Vitamin D Def. Osteoporosis
28
In patients with Primary Biliary Cholangitis, what can be elevated if they are asymptomatic?
Alkaline phosphatase
29
Primary Sclerosing Cholangitis
Inflammation and fibrosis of large intrahepatic ducts and extrahepatic ducts with dilation of other segments
30
Inflammation and fibrosis of large intrahepatic ducts and extrahepatic ducts with dilation of other segments
Primary Sclerosing Cholangitis
31
Who is commonly affected with Primary Sclerosing Cholangitis?
Males 30-50 with ULCERATIVE COLITIS
32
What disease do those with Primary Sclerosing Cholangitis usually have?
Ulcerative Colitis (IBD)
33
There are no specific antibodies associated with Primary Sclerosing Cholangitis, but what is usually (+)?
pANCA - ulcerative colitis
34
(+) pANCA may correlate with what autoimmune cholangiopathy?
Primary Sclerosing Cholangitis
35
What HLA is Primary Sclerosing Cholangitis associated with?
HLA-B8
36
What are the morphologic findings with Primary Sclerosing Cholangitis?
Onion skin fibrosis that turns into tombstone scar
37
Onion skin fibrosis that turns into tombstone scar
Primary Sclerosing Cholangitis
38
Symptoms of Primary Sclerosing Cholangitis?
Fatigue, jaundice, pruritus
39
Symptoms of Primary Sclerosing Cholangitis?
Fatigue, jaundice, pruritus
40
What other issues can Primary Sclerosing Cholangitis be associated with?
Ascending Cholangitis | Chronic pancreatitis/cholecystitis
41
What other issues can Primary Sclerosing Cholangitis be associated with?
Ascending Cholangitis | Chronic pancreatitis/cholecystitis
42
What will be seen on ERCP/MRCP with Primary Sclerosing Cholangitis?
Beading of biliary tree due to strictures and dilations
43
What will be seen on ERCP/MRCP with Primary Sclerosing Cholangitis?
Beading of biliary tree due to strictures and dilations
44
Beading of the biliary tree is seen with?
Primary Sclerosing Cholangitis

GI - 2 (61 decks)

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