91 下列何種疾病最常伴隨原發性硬化性膽管炎（primary sclerosing cholangitis）？
(A)全身性紅斑性狼瘡（systemic lupus erythematosus）
(B)葛雷夫氏病（Graves’ disease）
(C)胰臟炎（pancreatitis）
(D)潰瘍性結腸炎（ulcerative colitis）

Bile duct radical, surrounded by fibrous tissue, bloody diarrhea with LLQ crampy pain, jaundice – what is the IBDz? UC

Common bile duct surrounded by fibrous tissue – dx? Primary sclerosing cholangitis.  MCC primary sclerosing cholangitis = UC

What cancer can develop b/c it involves the bile duct? Cholangiocarcinoma (MCC in this country, in 3 rd  world countries, it is due to Clonorchis sinensis – Chinese liver fluke).

Primary Biliary cirrhosis

50 y/o woman with generalized itching, find enlarged liver on PE, normal bilirubin (no jaundice), alk phos and gamma glutamyl transferase are huge (obstructive type of enzymes), transaminases are elevated – dx?   Primary biliary cirrhosis, which is  an autoimmune dz that leads to granulomatous destruction of the bile ducts in the portal triad .  What is the Ab to order in this pt? Anti-mitochondrial antibodies (antimicrosomal = hashimoto’s).