qqqqqq - usmle_guy

[ArchivalUser]

A 35 year-old male with ulcerative colitis presents to his gastroenterologist for one week of jaundice, itching and right upper quadrant pain. Physical exam is notable for icteric sclera, excoriations on the upper shoulder and pain on palpation of the right upper quadrant.
Liver function tests are sent that show:
Total bilirubin 5.3
Direct bilirubin 4.1
AST: 45
ALT: 50
Alkaline Phosphatase: 150

A decision is made for the patient to undergo an ERCP and the cholangiogram shows alternative strictures and dilations.

Which antibody is most commonly associated with this condition?

A. ASCA (Anti-Saccharomyces cerevisiae antibodies )
B. Anti-mitochondrial antibody
C. Anti-smooth muscle antibody
D. C-ANCA
E. P-ANCA

[ArchivalUser]

b???

[ArchivalUser]

bbb..primary biliary cirosis

[ArchivalUser]

try again

[ArchivalUser]

ccc?

[ArchivalUser]

ee

[ArchivalUser]

ok...so we have increase in diirect bilirubin....so that mean we have a lot of hemolisis or deficit in conjugation... it may me P anca too...;(

[ArchivalUser]

finally...U did it...Yes E....This is PSC..associated with UC....80% cases of PSC associated with positive P-ANCA.....Dont forget our favourite disease..Churg Strauss and microscopic polyangitis..