Type 2 autoimmune pancreatitis also called
Idiopathic duct centric pancreatitis. No igg4 positive cell but characterized by granulocytic lesion
Can associate with inflammatory bowel diseaae
First line treatment of autoimmune pancreatitis type 1
And second line
Prednisone
6-mercaptopurine. Azathioprine, mycophenolate, rituximab. These are slow onset, not use for induction therapy, just use in the maintenance phase of therapy for recurrent disease
Antibody in primary biliary cholangitis
Antimicrobial antibody
Primary biliary cholangitis is more common in sex?
Female 9:1
In PBC if antimitochodrial antibody is negative. Which pbc-specific antibodies should be check
Sp100 and gp 210
First line treatment of pbc
Ursodeoxycholic acid
Which size of bile duct does pbc affect
Small and medium
Which size of bile duct does primary sclerosing cholangitis affect
Large
Psc can affect which sex
Male more than female
Associate with IBD in 85% of cases
In psc what if elevated bilirubin and total protein
Presence of hypergammaglobulinemia
Which anitibody in psc
Sometimes Anti smooth muscle antibody
What disease has positive anti smooth muscle antibody
Psc and anutoimmune hepatitis
Autoimmune pancreatitis may be associated with secondary sclerosing cholangitis
Abx for uncomplicated diverticulitis
Cefepime + metronidazole
A beta lactam
A beta lactam+beta lactamase inhibitor
Meropenem
When we treat uncomplicated diverticulitis with oral abx
Stable, immunocompetent
How high is meld score of acute alcohol hepatitis to begin prednisolone and N acetyl cystein
20
How long should continue prednisolone on acute alcohol hepatitis
28 days. If not response will discontinue after 4-7 days.
Colonoscopy done every 5-10 years when
One or two small < 10 mm sessile serrated polyp without dysplasia
Colonoscopy done every 3-5 years
3-4 polyps
Colonoscopy done 3 years
5-10 polyps > 10mm
Polyps > 10mm
Colonoscopy for multiple <= 20 and small < 10mm hyperplastic polyps in the rectum or sigmoid colon or proximal to the sigmoid or rectum
10 years
How to diagnose celiac disease on iga deficiency patients
Check anti deaminated gliadin peptide igg antibodies
When should we check hla-dq2 and hla-dq8 on celiac disease
On who have not had serologic testing before starting gluten free diet
When the result of celiac specific serology and histology are discrepant
Who should receive HAV immune globulin and HAV vaccine
Patient older than 40, chronic liver disease and immunosuppression
