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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 Sclerosing ... #psc #hepatology
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Tests - Differential ... Algorithm for Transaminitis ... Congenital, Others, Cirrhosis ... Algorithm #diagnosis #hepatology
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Cirrhosis (PBC) ... /Liver failure ... or higher • Liver ... bile ducts Differential ... diagnosis #workup #hepatology
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... of autoimmune disease ... Liver biopsy findings ... #PBC #Primary
Liver Mass Differential Diagnosis
Solid:
 • Benign: Hepatic Hemangioma, Focal nodular hyperplasia, Hepatocellular adenoma, Regenerative nodules
 •
Liver Mass Differential ... disease, Biliary ... Cystadenocarcinoma, Primary ... #Mass #Differential ... #Diagnosis #hepatology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... congenital - Primary ... Nonalcoholic fatty liver ... #Diagnosis #Differential ... #Hepatology #Cirrhosis
Liver Mass - Differential Diagnosis Algorithm
Cystic:
 • Benign 
     - Simple: Simple
Liver Mass - Differential ... Disease, Caroli's ... Malignant - primary ... - HCC, CCA, HB ... Algorithm #Causes #Hepatology
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm

ALP:
 - Enzymes that catalyze hydrolysis of organic phosphate
ALP) Elevation - Differential ... disturbance (obstructed liver ... Highest • Bone • Liver ... - Drugs - Primary ... ALP #Elevation #Differential
Autoantibodies and their Disease Associations
ANA - Non-specific; common in SLE, autoimmune hepatitis
Anti-CCP, Rheumatoid factor - RA
Anti-dsDNA
Dermatomyositis Anti-LKM (liver ... , Anti-gp210 - Primary ... biliary cirrhosis ... (PBC) Anticentromere ... Endomyseal antibody (EMA
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Hepatomegaly - Differential ... Non-Malignant • Fatty Liver ... Hemochromatosis • Wilson's Disease ... Biliary Cirrhosis ... Algorithm #Causes #Hepatology