PBC PSC Exam Questions & Answers
2025/2026
PSC - ANSWERScondition where the intrahepatic or extrahepatic ducts become strictured
(narrowed) and fibrotic (hardened).
This causes an obstruction to the flow of bile out of the liver and into the intestines.
Sclerosis refers to the stiffening and hardening of the bile ducts, and cholangitis is inflammation
of the bile ducts.
Chronic bile obstruction (backpressure of bile) eventually leads to liver inflammation (hepatitis),
fibrosis and cirrhosis.
PSC association - ANSWERSulcerative colitis, with around 70% of cases being alongside
established ulcerative colitis.
PSC risk factors - ANSWERSMale
Aged 30-40
Ulcerative Colitis
Family History
signs & symptoms PSC (5) - ANSWERSJaundice
Chronic right upper quadrant pain
Pruritus
Fatigue
, Hepatomegaly
which autoantibodies are specific to PSC? - ANSWERSnone
but these can indicate if disease is autoimmune & pt would benefit from immunosuppression
p-ANCA
ANA
ACL
LFT with PSC - ANSWERS"cholestatic" picture. This means alkaline phosphatase is the most
deranged LFT and may be the only abnormality at first.
bilirubin may raise
ALT & AST can also be deranged
gold standard diagnosis for PSC - ANSWERSMRCP - magnetic resonance
cholangiopancreatography
-MRI scan of liver, bile duct, pancreas
may show bile duct lesions or strictures
associations & complications of PSC - ANSWERSAcute bacterial cholangitis
Cholangiocarcinoma develops in 10-20% of cases
Colorectal cancer
2025/2026
PSC - ANSWERScondition where the intrahepatic or extrahepatic ducts become strictured
(narrowed) and fibrotic (hardened).
This causes an obstruction to the flow of bile out of the liver and into the intestines.
Sclerosis refers to the stiffening and hardening of the bile ducts, and cholangitis is inflammation
of the bile ducts.
Chronic bile obstruction (backpressure of bile) eventually leads to liver inflammation (hepatitis),
fibrosis and cirrhosis.
PSC association - ANSWERSulcerative colitis, with around 70% of cases being alongside
established ulcerative colitis.
PSC risk factors - ANSWERSMale
Aged 30-40
Ulcerative Colitis
Family History
signs & symptoms PSC (5) - ANSWERSJaundice
Chronic right upper quadrant pain
Pruritus
Fatigue
, Hepatomegaly
which autoantibodies are specific to PSC? - ANSWERSnone
but these can indicate if disease is autoimmune & pt would benefit from immunosuppression
p-ANCA
ANA
ACL
LFT with PSC - ANSWERS"cholestatic" picture. This means alkaline phosphatase is the most
deranged LFT and may be the only abnormality at first.
bilirubin may raise
ALT & AST can also be deranged
gold standard diagnosis for PSC - ANSWERSMRCP - magnetic resonance
cholangiopancreatography
-MRI scan of liver, bile duct, pancreas
may show bile duct lesions or strictures
associations & complications of PSC - ANSWERSAcute bacterial cholangitis
Cholangiocarcinoma develops in 10-20% of cases
Colorectal cancer
