Chronic Cholestatic Biliary Diseases Flashcards Preview

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Flashcards in Chronic Cholestatic Biliary Diseases Deck (15):
1

epidemiology of primary biliary cirrhosis

- female:male is 9:1
- most common chronic cholestatic liver disease in adults

2

pathogenesis of PBC

- lymphocyte and plasma cell destruction of small ductules within the liver
- focal duct obliteration with granuloma formation

3

symptoms of PBC

- profound pruritus (bile salts get into periphery and activate histamine)
- fatigue is most common symptom

4

diagnosis of PBC

- increased cholestatic enzymes (BA, GGTP, Alk. phosp)
- cholesterol and IgM increased
- jaundice and low albumin

5

potential risk factors

- anti-mitochondiral antibody M2 similar to E. coli on inner mitochondrial membrane
- complicated by osteodystrophy: inability to absorb fat soluble vitamins

6

associated syndromes with PBC

- Sicca, Sjogrens, CREST, scleroderma, thyroiditis, telangectasia

7

autoimmune cholangitis

- AMA negative PBC
- antinuclear antibody (ANA) and antismooth muscle antibody (ASMA) usually positive
- treat with ursodiol and steroids if necessary

8

primary sclerosing cholangitis

- intra and extrahepatic large ducts involved
- many PSC patients have UC

9

cholangitis is a infection of biliary system defined by Charcot's triad

- elevated liver enzymes, fever, RUQ pain

10

diagnosis of PSC

- MRCP

11

treatment of PSC

- liver transplant

12

Caroli's disease

- cystic dilatation of intrahepatic bile ducts
- prone to develop recurrent cholangitis
- slow destruction of liver

13

PTC

- radiologic technique used to visualize the anatomy of the biliary tract
- A contrast medium is injected into a bile duct in the liver, after which X-rays are taken
- It allows access to the biliary tree in cases where endoscopic retrograde cholangiopancreatography (ERCP) has been unsuccessful

14

ERCP

- Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject radiographic contrast into the ducts in the biliary tree and pancreas so they can be seen on X-rays

15

MRCP

- medical imaging technique that uses magnetic resonance imaging to visualise the biliary and pancreatic ducts in a non-invasive manner