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Old 07-14-2012
tyagee's Avatar
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Liver Post transplant jaundice !

A 23-year-old man who recently underwent bone marrow transplantation for acute myelogenous leukemia complains of fever, severe diarrhea, pruritis, and jaundice. Liver biopsy shows a markedly decreased quantity of bile ducts. Which of the following conditions is characterized by the same pattern of liver injury?

A. Acetaminophen toxicity
B. Alcoholic liver disease
C. Primary sclerosing cholangitis
D. Primary biliary cirrhosis
E. Total parenteral nutrition
F. Chronic hepatitis B

please do give expln!

Last edited by tyagee; 07-14-2012 at 01:39 PM.
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Old 07-14-2012
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Answer is D
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Old 07-14-2012
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Help ..

I think D is the answer.
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Old 07-14-2012
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D. Primary biliary cirrhosis

A continuous destruction of small and medium bile ducts occurs, which is mediated by activated CD4 and CD8 lymphocytes. As a result, chronic cholestasis is the prominent clinical and laboratory finding. Once destroyed, it is well established that regeneration of bile ducts is either not possible or inefficient.

Subsequent to the loss of the intrahepatic bile ducts, a disruption of the normal bile flow occurs with retention and deposition of toxic substances, which are normally excreted into bile. The retention of toxic substances, such as bile acids and copper, can cause a further secondary destruction of the bile ducts and the hepatocytes. In addition, increased expression of the HLA class II antigens in the liver occurs, rendering hepatocytes and bile duct epithelial cells more susceptible to activated T lymphocytes and perhaps exacerbating immunologically mediated cytotoxicity.
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tyagee (07-14-2012)


Gastroenterology-, Step-2-Questions

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