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Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Primary Biliary ... intralobular bile ducts causes ... cholestasis → Cirrhosis/Liver ... hyperpigmentation • Jaundice ... or higher • Liver
Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... and Biliary Diseases ... erythema 2) Face: Jaundice ... Xanthelasma and jaundiced ... Bruising, Edema #biliary
Diseases of the Biliary Tract
Asymptomatic gallstones - Asymptomatic
Symptomatic gallstones - Biliary pain
Cholesterolosis of gallbladder - Usually
Diseases of the Biliary ... Adenomyomatosis - May cause ... quadrant pain, nausea ... quadrant pain, nausea ... pain, jaundice,
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Classification of Jaundice ... postoperative jaundice ... miscellaneous causes ... neoplasms #Jaundice ... #differential #causes
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe ... Acute Liver Injury ... hepatitis - Acute biliary ... - Drug-Induced liver ... Severe #Acute #Causes
Jaundice - Differential Diagnosis Algorithm
Pre-Hepatic - Unconjugated Hyperbilirubinemia
Increased Production
 • Hemolysis
 • Ineffective Erythropoiesis
 • Hematoma
Decreased
Jaundice - Differential ... on Ultrasound Biliary ... Gallstones • Biliary ... Cholangitis #Jaundice ... Diagnosis #Algorithm #Causes
Right Upper Quadrant Pain
Liver:
 - Infectious: Acute viral hepatitis, Liver abscess
 - Non-infectious: hepatitis (Alcohol, Medications),
Quadrant Pain Liver ... viral hepatitis, Liver ... Budd-Chiari syndrome Biliary ... "biliary colic") ... differential #diagnosis #causes
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Causes of Acute ... Hepatocellular - Liver ... hepatitis, Acute biliary ... Extrahepatic • Biliary ... Differential #Diagnosis #Causes
Jaundice - Pathophysiology and Causes

- Amy Chung, MD, MSc @AmyChung 

#Jaundice #Pathophysiology #Differential #Unconjugated #Causes #Diagnosis
Jaundice - Pathophysiology ... and Causes - ... @AmyChung #Jaundice ... #Unconjugated #Causes
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... discomfort Signs: Jaundice ... Liver biopsy findings ... #PBC #Primary #Biliary