AAAAA
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39 y/o m aymptomatic presented with insurance examination. PMH is significant for protocolectomy 8 y/ ago for refractive ulcerative colitis.
Exam. nl Lab. ALP 5 fold elevation, ALT 2 fold elevation
Which of the following would be the appropriate next step?
1. Fractionation of th ALP
2. Fractionation of the ALT
3. AMA antimitochrondrial antibody
4. MRCP
5. ANCA
Remember what is MRA, what is MRCP M=magnetic MRA=magnetic resonance angiography
MRCP= magnetic resonance cholanpancreatography
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| AAAAA
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It this is a 38 year-old woman with no ulcaerative colitis.
What is the best choices
The same five choices (except now it is a woman and no UC !!)
Always think about the age and gender m, or w man vs woman , age group !!! in exam
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| AAAAA
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Very interesting management
in male or female patient !
Totally different management !
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| focussed
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Ans. next step is AMA antimitochondrial antibody.association of sclerosing cholangitis and ulcerative colitis
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| Isther
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AMA is most sensible for primary biliary cirrhosis... don't know if is used also for sclerosing cholang.
For the guy, MRCP since sclerosing cholangitis has increased risk for cholangiocarcinoma.
For the lady with no UC, AMA for PBC
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| karusmle
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answer plz
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| guayoman
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I agree with Isther. Nice logical conclusion givn the options.
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| AAAAA
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39 y/0 man----elevated LFT------MRCP (answer 4)
For 38 y/o woman--------elevated LFT---------AMA (primary biliary cirrhois) not used for sclerosing cholangitis
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