Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Biliary Tract Disease > Flashcards

Biliary Tract Disease Flashcards

1
Q

what are the symptoms of gall stones

A

most asymptomatic- colic, cholecystitis, jaundice, pancreatitis, bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what causes gall stones

A

abnormal bile consumption, bile stasis, infection,

excess cholesterol, excess bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the different types of gall stones

A

cholesterol, pigment, primary bile duct stones, mixed (cholesterol and bilirubin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the risk factors for gallstones

A

the five F’s

age >40
female
high fat diet + obesity 
pregnancy (fertile)
hyperlipidaemia 
crohns (bile salt loss)
diabetes 
dysmotility of GB
prolonged fasting
TPN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where is bile absorbed

A

the terminal part of the ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes biliary colic

A

when a stone impacts in the cycstic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the characteristics of biliary colic

A

gradual build up of pain in RUQ, radiates to back/ shoulder, may last 2-6 hours, associated with indigestion/ nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the causes of severe acute epigastric pain

A

biliary colic, peptic ulcer disease, oesophageal spasm, myocardial infarction, acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is acute cholecystitis

A

inflammation of the GB, due to obstruction of the cystic duct. initially sterile then becomes infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when is air present in the GB

A

not normally, air can come from duodenum or fistula or gas producing bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

are you expected to see stones on an x ray

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the gold standard for diagnosing stones

A

ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what investigations can be done to diagnose gallstones

A

ultrasound, CT scan, MRCP/ERCP, HIDA, EUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the positive of a CT in GS

A

looks at pancreas - can assess complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an MRCP

A

MRI of biliary system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is HIDA

A

nuclear medicine that looks at the motility of the gall bladder- measures ejection- less than 30% unhealthy. also measures the sphincter of oddi and gut function

17
Q

what is the treatment of acute cholecystitis

A

IV antibiotics and fluid

urgent cholecystectomy

interval cholecystectomy (removal after 6-12 weeks)

18
Q

What are the complications of gall stones

A

might migrate to CBD, gallstone ileus

19
Q

what happens when gallstones migrate to the CBD

A

jaundice, cholagitis, acute pancreatitis

20
Q

what are the presentations of common bile duct pathologies

A

itch, nausea, anorexia, jaundice, abnormal LFTs

21
Q

what is an ERCP

A

endoscope + stone removal

22
Q

what suggests there is a stone in the CBD

A

dilated bile duct with deranged LFTs

23
Q

what can cause acute pancreatitis

A

i get smashed

I- idiopathic

g-GS
e-ethanol
t-trauma

s-steroids
m-mumps (infections)/ malignancy 
a-autoimmune 
s-scorpion stings/ spider bites
h-hyperlipidaemia/ hypercalcaemia/ hyperparathyroidism (metabolic disorders)
E-ERCP
d-drugs
24
Q

what does acute pancreatitis cause

A

autodigestion of peri-pancreatic tissues by activated enzymes

25
Q

how is acute pancreatitis treated

A

rehydration, cholecystectomy, ERCP/ endoscope

26
Q

what is a gallstone ileus

A

small bowel obstruction due to impacted gallstone in distal ileum

27
Q

when can a large gallstone pass into small intestine

A

fistula that allows gallstone to pass into duodenum

28
Q

what does a gallstone do as it moves down the small bowel

A

causes intermittent colic

29
Q

how do gall stone ileus present

A

with distal small bowel obstruction

30
Q

what is the treatment for a gallstone ileus

A

urgent laparotomy (SB enetrotomy to remove stone), interval cholecystecomy in 3 months

31
Q

what is cholangiocarcinoma

A

cancer in the bile duct, 2nd most common hepatocelullar cancer

32
Q

how do cholangiocancinomas present

A

jaundice, weight loss, anorexia, lethargy

50% lymph node metastases, 20-30% peritoneal metastases

33
Q

how is cholangiocarcioma stages

A

duplex ultrasound, spiral CT/ ERCP/ PTC),

MRI/MRCP/MRA

34
Q

how are hilar cholangiocarcinomas classified

A

on how far they extend past the confluence and into the right and left hepatic ducts

35
Q

what is the only chance of cure of cholangiocarcinoma

A

surgical resection of bile duct and liver

36
Q

what are the palliation options for cholangiocarcinoma

A

biliary stent, ERc/PTC insertion

37
Q

what is an ERC

A

endoscopic retrograde cholangiography

38
Q

what is a PTC

A

Percutaneous transhepatic cholangiography (same as PTHC)

GI (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions