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Pathologic Red Blood Cell (RBC) Morphologies and Associated Diseases

Acanthocyte (spur cell),  
Basophilic stippling, 
Bite cell,
Basophilic stippling, Bite ... cell, Elliptocyte
Mechanism of Action of Bile Acid Sequestrants
Bile Acid Sequestrants → ↓ Hepatic Bile Acid Pool →
Mechanism of Action of Bile ... Sequestrants Bile ... Sequestrants → ↓ Hepatic Bile ... Pool → ↑ Hepatic Bile ... Plasma LDL-C #biliary
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
genes coding for bile ... Dysfunction - Biliary ... certain drugs, biliary ... , carcinoma of biliary ... external pressure on bile
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... gradual loss of bile ... inflammation and biliary ... #PBC #Primary #Biliary
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
disease US — Normal Bile ... US - Dilated Bile ... Ducts • Common Bile ... Duct Stone • Biliary
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Primary Biliary ... small intralobular bile ... of intralobular bile ... No extrahepatic biliary ... malignancy #Primary #Biliary
Indications for ERCP
1. Biliary Tract Diseases:
 • Biliary obstruction: Choledocholithiasis, Malignant biliary strictures, Benign biliary strictures
Biliary Tract Diseases ... : • Biliary obstruction ... Choledocholithiasis, Malignant biliary ... strictures, Benign biliary ... Oddi manometry • Bile
Common Bile Duct Biliary Stone removal on ERCP

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Biliary #Stone #removal #extraction #ERCP
Common Bile Duct ... Biliary Stone removal ... DrJBerrueta #Biliary
Morphologic Findings in Red Blood Cells
Basophilic stippling - Small blue dots in red cells, due to
Heinz bodies (Bite ... Bite cells: sharp ... bite-like defects ... cell membrane Elliptocytes
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
• US - Normal Bile ... • US - Dilated Bile ... - CBD stone, Biliary