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  #1  
Old 09-29-2012
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Liver Liver Biopsy Result - LAB Diagnosis

Liver biopsy was done on 23 y.o. woman with elevated liver function tests. She has no alcohol consumption history and no viral serologic markers. Biopsy reveals infiltration of the portal and periportal area with lymphocytes. Phyisician suspects diagnosis and orders lab-test to confirm it. which of the following is usefull in confirmation of the diagnosis:

a) Antimitochondrial AB-s
b) UDP-glucuronyl Transferase activity measurement
c) LKM Ab test
d) P-ANCA
e) Plasma IgM Levels.
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Old 09-29-2012
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A) Antimitochondrial Antibody? Thinking it's Primary Biliary Cirrhosis?
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Old 09-29-2012
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would also go with A) AMAb's...due to lymphocytic infiltrate and jaundice history not give
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hi. the answer is LKM antibody. this sounded like what the f*ck at first but
so that question was in DIT 2012. it is autoimmune hepatitis not primary biliary cirrhosis. PBC is characterized by granulomas(FA 2012 365) not just inflitrates of lymphocytes .
LKM 1 is L-iver K-idney Microsomal antibody and it's positive in autoimmune hepatitis. anti smooth muscle ab is also positive. antimicrosomal ab(not LKM) is also positive in hashimoto.
it's kind of confusing, but you know how usmle likes different kinds of antibodies. Since it was in DIT i decided to share.
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Quote:
Originally Posted by beka-CTS View Post
hi. the answer is LKM antibody. this sounded like what the f*ck at first but
so that question was in DIT 2012. it is autoimmune hepatitis not primary biliary cirrhosis. PBC is characterized by granulomas(FA 2012 365) not just inflitrates of lymphocytes .
LKM 1 is L-iver K-idney Microsomal antibody and it's positive in autoimmune hepatitis. anti smooth muscle ab is also positive. antimicrosomal ab(not LKM) is also positive in hashimoto.
it's kind of confusing, but you know how usmle likes different kinds of antibodies. Since it was in DIT i decided to share.
Wow, nice question! Please post more stuff if you can find, I won't be doing DIT and stuff so!
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Wondering where to add this in FA so I can remember this though. The page which lists all the antibodies, where Autoimmune hepatitis as anti-SM is also given? Any ideas?
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Quote:
Originally Posted by dockhi View Post
Wondering where to add this in FA so I can remember this though. The page which lists all the antibodies, where Autoimmune hepatitis as anti-SM is also given? Any ideas?
add in immuno section where every antibody is listed + also add it in GI liver pathology to make sure that you'll remember it.
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thanks for the question and explanation too...
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Old 10-01-2012
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Yes i read it in Robbins and then forgot
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Quote:
Originally Posted by beka-CTS View Post
hi. the answer is LKM antibody. this sounded like what the f*ck at first but
so that question was in DIT 2012. it is autoimmune hepatitis not primary biliary cirrhosis. PBC is characterized by granulomas(FA 2012 365) not just inflitrates of lymphocytes .
LKM 1 is L-iver K-idney Microsomal antibody and it's positive in autoimmune hepatitis. anti smooth muscle ab is also positive. antimicrosomal ab(not LKM) is also positive in hashimoto.
it's kind of confusing, but you know how usmle likes different kinds of antibodies. Since it was in DIT i decided to share.
If there was option for anti smooth muscle Ab, Would it have been the right answer? because Type 1 autoimmune Hepatitis is more common than type 2 with elevated LKM Ab. plz explain..
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Old 10-01-2012
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Quote:
Originally Posted by Janakpriya View Post
If there was option for anti smooth muscle Ab, Would it have been the right answer? because Type 1 autoimmune Hepatitis is more common than type 2 with elevated LKM Ab. plz explain..
of course ASM AB would have been the right answer if given.
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