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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 ... Cholangitis #pathophysiology ... #comparison
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
- Differential Diagnosis ... Chronic liver disease ... Fitz-Hugh-Curtis syndrome ... Failure, Pancreatic, Biliary ... #hepatology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Nonalcoholic fatty liver ... disease (Budd-Chiari syndrome ... 14 percent) #Diagnosis ... #Differential #Hepatology
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... quadrant discomfort Signs ... Liver biopsy findings ... #Cirrhosis #Diagnosis
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... and hepatorenal syndrome ... sarcoidosis) • Liver ... pregnancy • Primary biliary ... #causes #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... protein ≤ 2.5 g/dL: Cirrhosis ... , Massive liver ... SAAG < 1.1: Biliary ... albumin #gradient #hepatology
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
65 years PBC Pathophysiology ... /Liver failure ... PBC Signs and ... or higher • Liver ... #workup #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
- Differential Diagnosis ... Non-Malignant • Fatty Liver ... • Budd-Chiari Syndrome ... Cholangitis • Primary Biliary ... Cirrhosis #Hepatomegaly
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
clinical symptoms/signs ... presence of metabolic syndrome ... Areas of diagnostic ... include extrahepatic biliary ... Abnormal #Algorithm #Hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
- Differential Diagnosis ... - Hepatic: • Cirrhosis ... disease • Acute liver ... failure • Primary biliary ... #Algorithm #Hepatology