Biliary

Question 1

Medications associated with gallstones

Answer 1

oral contraceptives, hormone replacement therapy,

ceftriaxone, fibrates, calcineurin inhibitors and octreotide

Question 2

cholesterol gallstones vs pigmented gallstones (percent cholesterol)?

Answer 2

> 50 percent cholesterol by weight.

<30 percent cholesterol by weight.

Question 3

recurrent biliary events occur in how frequently if cholecystectomy is delayed beyond the initial hospitalization?

Answer 3

20-40%

Question 4

pancreaticobiliary maljunction? Increased risk of this malignancy?

Treat if?

Answer 4

junction of the pancreatic and bile ducts located outside the duodenal wall, usually forming a markedly long common channel

Gallbladder cancer >cholangiocarcinoma

Cholecystectomy for all. Extra hepatic duct resection if dilated biliary duct

Question 5

most common clinical presentation of a choledochocele?

Answer 5

Pancreatitis&raquo_space; obstructive jaundice

Question 6

patients with cirrhosis and intrahepatic cholangiocarcinoma who otherwise qualify as candidates for liver transplantation can be considered for transplantation if?

Answer 6

single lesion less than or equal to three centimeters in diameter, no evidence of vascular invasion or extrahepatic disease, and no history of prior attempted resection

Question 7

first line chemotherapy in patients with advanced stage intrahepatic carcinoma who are not candidates for locoregional therapy or surgery?

Answer 7

Gemcitabine and cisplatin

Question 8

After OLT, Non-anastomotic strictures typically develop at?

Are usually due to ischemia or? (Examples?)

Answer 8

hilum and/or the intrahepatic ducts

immune-mediated processes (ABO-incompatible graft or chronic ductopenic rejection).

Question 9

Required to establish a diagnosis of recurrent PSC after transplant?

Answer 9

Cholangiographic or histologic evidence of PSC at least three months following transplant

Question 10

PBC - histologic finding?

Initial treatment? (With dose)

Answer 10

Florid duct lesion

Ursodiol 13-15 mg/kg/day

Question 11

progressive familial intrahepatic cholestasis type III.

Gene?

Mode of inheritance?

Lab abnormality that is unique to this type?

Answer 11

ABCB4

Autosomal recessive

Question 12

Effect of estrogen on gallbladder function?

Progesterone?

Answer 12

Cholelithiasis

Impaired GB motility

Question 13

Pigmented gallstones are composed of? (Unpigmented stones?)

Risk factors for black stones?

Brown stones?

Answer 13

calcium hydrogen bilirubinate (cholesterol)

hemolysis (example, sickle cell disease), cirrhosis, cystic fibrosis, and diseases of the ileum (CD)

biliary stasis (example, biliary stricture) and infection (example, Clonorchis sinensis)