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Cholestatic Liver Disease: Primary Biliary Cirrhosis vs Primary Sclerosing Cholangitis

#pathophysiology #pbc #psc #hepatology #comparison
Cholestatic Liver ... Disease: Primary Biliary ... Cirrhosis vs Primary ... #pbc #psc #hepatology ... #comparison
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Nonalcoholic fatty liver ... 14 percent) #Diagnosis ... #Differential #Hepatology ... #Cirrhosis #Causes
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Cholangitis • Primary Biliary ... Cirrhosis #Hepatomegaly ... #Algorithm #Causes ... #Hepatology
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... Liver biopsy findings ... #Cirrhosis #Diagnosis ... #Algorithm #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... Infiltrative • Cirrhosis ... Duct Stone • Biliary ... Others #LFTs #Hepatology ... #Algorithm #Causes
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
protein ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... syndrome SAAG < 1.1: Biliary ... albumin #gradient #hepatology ... #algorithm
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Hepatic: • Cirrhosis ... disease • Acute liver ... failure • Primary biliary ... #Algorithm #Hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... sarcoidosis) • Liver ... pregnancy • Primary biliary ... #Differential #Diagnosis ... #causes #hepatology
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Causes of Acute ... Diagnosis Hepatocellular ... hepatitis, Acute biliary ... #Causes #Acute ... #algorithm #hepatology
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
65 years PBC Pathophysiology ... intralobular bile ducts causes ... /Liver failure ... or higher • Liver ... #workup #hepatology