Primary Sclerosing Cholangitis (PSC) By: Andres Perez & Adriana Lopez

Primary Sclerosing Cholangitis (PSC) Is a disease in the digestive system where the Bile Ducts are blocked & damaged outside & inside the liver. The Bile Ducts are the tubes that carry out the Bile from the liver into the Gallbladder and Small Intestine. The Bile is the liquid which is made inside the liver & helps break down fat in foods.

Progression of PSC Inflammation of the Bile Ducts lead to scarring that narrows the bile ducts Inflammation of the Bile Ducts lead to scarring that narrows the bile ducts and if worsen; the scarring could in time lead to blocked Bile Ducts& that could lead to Cirrhosis & Liver Failure since the bile cannot continue its routine.

Symptoms The main symptoms of PSC are: 6 out of 100,000 people Itching of the Skin (may occur when toxins in bile get into the bloodstream) Fatigue Jaundice Can cause chills and fever. 6 out of 100,000 people **Having family members with PSC may increase a person's risk of developing PSC.** In the United States 6 out of 100,000 people are diagnosed with PSC; average age of diagnosis is at 40 (can also occur in children). PSC is more common in men; approximately 70% of PSC patients are men. A person can have the disease for years before symptoms develop.

Advanced Effects As the disease progresses: chronic fatigue loss of appetite weight loss In the advanced stages, swelling can occur in the abdomen and feet. Liver failure may take many years to develop.

Complications of PSC Main complications that occur due to PSC include: Deficiencies in Vitamins A, D, E, & K Infections of the Bile Ducts Cirrhosis-Extensive scarring of the liver Liver Failure Bile Duct Cancer

Causes of PSC The causes for PSC are not yet known. Genetic Immune System disorder Bacteria Virus all these are believed to play roles in the development of the disease.

Treatment Treatment of PSC targets the relieving of symptoms and is meant to manage complications. Medical treatment may include Various medications to relieve itching Antibiotics to treat infections Vitamin supplements Instruments Liver transplantation may be an option if the liver begins to fail. Although researchers have studied many treatments, none has been made known to cure or slow the progress of PSC.

Diagnosis Cholangiography can be performed in the following ways: Blood tests to check levels of liver enzymes are the first step in diagnosing PSC. Cholangiography can be performed in the following ways: Endoscopic Retrograde Cholangiopancreatography (ERCP) Percutaneous Trans Hepatic Cholangiography (PTHC) Magnetic Resonance Cholangiopancreatography(MRCP) Other testing may include ultrasound exams and a liver biopsy. ). ERCP uses an endoscope—a long, flexible, lighted tube—that goes down the mouth, into the duodenum where dye is injected into the bile ducts. X rays are taken. Percutaneous Trans Hepatic Cholangiography. A needle is inserted through the skin and places a thin tube into a duct in the liver. Dye is injected through the tube and x rays are taken. ). MRCP uses Magnetic Resonance Imaging (MRI) to take pictures of the bile ducts. MRI machines use radio waves and magnets. MRCP does not involve using x rays or inserting devices into the body. This safe and painless test is increasingly used for diagnosis. Ultrasound uses sound waves to create images of organs inside the body. A biopsy involves removal of a small piece of tissue for analysis with a microscope.

Effects of Primary Sclerosing Cholangitis (PSC) Deficiency of vitamin A, D, E and K Liver Failure Liver Cancer Cirrhosis Muscular and skeletal system malfunctions it could cause other parts of the body to malfunction which can lead to deformities that at most times are permanent and cause life-long problems.

Quiz 1) What is PSC? 2) What are the causes of PSC? A. A problem with your bladder B. Scarring of the stomach C. Scarring of the bile duct and liver D. Painful digestion 2) What are the causes of PSC? A. Constant digestion of spicy foods B. Being outside for more than 3 hours C. Digestion of junk food D. It is not yet known

Quiz 3) What are the 4 different vitamins that are affected in the body? A. Vitamin A, D, E & K B. Vitamins U, E, K, P C. Vitamins B, C, T & D D. Vitamins H, B, K, D 4) What is one of the advanced effects of PSC? A. Complications of the Pancreas B. Hallucinations C. Chronic Fatigue D. Heartburn

Questions? Thank You

Vitamins A, D, E & K Vitamin A: Vitamin E: Vitamin K: Vitamin D: Antioxidant Anti-Infection Immunity Booster Vitamin E: Skin Protectant Cancer Prevention Metabolism Booster Prevention of Alzheimer's. Vitamin K: Blood clot reducer reduce risk of Osteoporosis Reduces the threat of bleeding in liver blood sugar regulator. Vitamin D: Calcium and Phosphorus Absorber Arthritis Preventer Blood Pressure Regulator Tension and Stress Reducer Vitamin A:Helps avoid night blindness Helps to preserve eyesight(prevents cataracts), can decrease your chances of certain cancers, heart disease & stroke. Vitamin E:

Vitamin D Deficiency Vitamin D is one of four vitamins that lacks presence in the body; without Vitamin D in the body problems in the Skeletal & Muscular System could begin to develop. Vitamin D allows the body to absorb Calcium(Ca2+) ; without this vitamin these two systems could not function properly thus bone growth, & the ability to contract muscles would not be possible because the natural processes would be interrupted.

Skeletal System Low Levels of Ca2+ 1.Blood circulates through Parathyroid Gland, Ca2+below “set point” is detected. 2.Parathyroid Gland releases Parathyroid Hormone(PTH) and PTH travels through blood. 3.PTH travels through Haversian Canal to stimulate osteoclasts to work and break down the bone to release Ca2+ in the blood. 4.Kidneys release Vitamin D to the small intestine and more Ca2+ is absorbed from digested foods(more Ca2+ in blood). 5.Kidneys are also signaled to not release Ca2+ in urine which causes more Ca2+ in the blood. Resorption (the breaking down of old bone) occurs when there is low Ca2+ in the body; osteoclasts break down the bone in order to put Ca2+ into the body. If Vitamin D is lacking in the body then it would be difficult for the body to collect Ca2+ from the small intestine; resulting in the breaking down of more bone to provide the body with more Ca2+. This excessive breaking down of bone leads to brittle bones which causes easy damage to the skeletal system. Causes pain for the person & constant visits to the hospital due to broken bones.

Steps to Muscle Contraction: Muscular System Steps to Muscle Contraction: 1.Brain sends nerve signals to the skeletal muscle releasing Aretylcholine to muscles, Ach then causes Ca2+ to be released to muscles. 2.Ca2+ then binds to troponin, causing a change in shape, Tropomyosin then changes shape, rotating and revealing Actin binding site. 3.This allows myosin to bind to Actin and pull Actin. ATP then releases Actin/Myosin so Myosin can bind to another Actin and this repeats. 4. Ca2+ is then released from Troponin causing all molecules to go back to its original shape. Then Myosin cannot bind to Actin so the muscle is relaxed. If Vitamin D is not present in the body Calcium becomes low and affects the contraction of muscles. If the Ca2+ is not present then the Troponin cannot change its shape and it would not allow the Myosin to bind to the Actin. The body to becomes hard to control because of muscles are not being able to contract; causes the body to either become randomly or permanently limp.

Works Cited http://digestive.niddk.nih.gov/ddiseases/pubs/primarysclerosingcholangitis/index.aspx#complications http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001330/ http://www.antioxidantsdetective.com/benefits-of-vitamin-a.html http://www.newsmax.com/fastfeatures/health-benefits-of-vitamin/2010/11/12/id/370865 http://www.newsmax.com/FastFeatures/Health-benefits-vitamin-E/2011/02/01/id/369888 http://www.healthdiaries.com/eatthis/6-health-benefits-of-vitamin-k.html