gallstones

Question 1

what are gallstones

Answer 1

small stoned that form within gallbladder

most are made of cholsesterol

Question 2

cholestasis

Answer 2

blockage to flow of bile

Question 3

cholelithiasis

Answer 3

gallstones present

Question 4

choledocholithiasis

Answer 4

gallstones in bile duct

Question 5

biliary colic

Answer 5

intermittent RUQ pain

Question 6

cholecystitis

Answer 6

inflammation of gallbladder

Question 7

cholangitis

Answer 7

inflammation of bile ducts

Question 8

cholecystectomy

Answer 8

removal of gallbladder

Question 9

cholecystostomy

Answer 9

inserting drain into gallbladder

Question 10

risk facors

Answer 10

fat
fair
female
forty

Question 11

presentation

Answer 11

asymptomatic 
biliary colic 
severe, colicky RUQ pain
pain triggered by meals (esp high fat) 
N+V

Question 12

how does fatty meals affect gallstones

Answer 12

fat entering GIT causes CCK secretion from duodenum
CCK triggers contraction of gallbladder which leads to biliary colic

pt w gallstones + biliary collic advised to avoid fatty meals

Question 13

LFTs - bilirubin in obstructive picture

Answer 13

raised w dark urine and pale stools

Question 14

LFTs; - alkaline phosphatase in obstructive picture

Answer 14

raised ALP in prescence of RUQ pain and/or jaundice is consistent w obstruction

Question 15

LFTs - aminotransferase in obstructive picture

Answer 15

AST and ALT increase slightly, with higher rise in ALP

Question 16

LFTs - aminotransferase in hepatic pictrue

Answer 16

ALT and AST high compared to ALP

Question 17

first line Ix

Answer 17

USS

Question 18

main indication for ERCR

Answer 18

clear stones in bile ducts

Question 19

complications of ERCP

Answer 19

excessive bleeding
cholangitis
pancreatitis

Question 20

management

Answer 20

cholecystectomy

Question 21

when is cholecystectomy indicated

Answer 21

symptoms of gallstones

gallstones leading to complications

Question 22

complications of cholecystectomy

Answer 22

bleeding, pain
infection, scars
bile duct damage 
stones left
damage to bowel
anaesthetic risks 
VTE 
post-cholecystectomy syndrome

Question 23

post-cholecystectomy syndrome

Answer 23

diarrhoea
indigestion 
epigastric/RUQ pain
nausea
intolerant fatty foods
flatulence

Question 24

gallstone complications

Answer 24

acute cholecystitis
acute cholangitis
pancreatitis