Biliary disease

Question 1

Asymptomatic gallstone in the gallbladder is called

Answer 1

Cholethiasis

Question 2

3 factors that cause increased gallstone disease with age

Answer 2

1) decreased response to CCK
2) decreased motility
3) cholesterol saturation

Question 3

Risk factors for gallstone disease

Answer 3

Family Hx
Obesity
Age
gender and hormones

Question 4

Multiple pregnancy and high estrogen levels

Answer 4

increases risk of gallstones

- more cholesterol

Question 5

If gallstone blocks the gallbladder duct and walls become irritated

Answer 5

acute cholecystisis

Question 6

If the stone gets lodged in the CBD

Answer 6

Choledocholithiasis unless with infection -

ascending cholangitis

Question 7

If stone gets blocked at the pancreatic duct

Answer 7

Pancreatitis

Question 8

Constant RUQ due to cystic duct obstruction and distention of the GB - up to 24 hours

Answer 8

biliary colic

Question 9

Treatment of biliary colic

Answer 9

IV fluids
analgesic
Elective cholecystectomy

Question 10

3 bacteria that cause cholecystisis

Answer 10

E coli
Klebsiella
Enterococcus

Question 11

acute cholecystisis is

Answer 11

biliary colic > 24 hours

• fever
• tachycardia
• leukocytosis
• positive murphy’s sign

Question 12

How do you confirm the diagnosis of acute cholecystisis

Answer 12

Ultrasound

Question 13

3 things you must get from anyone with upper abdo pain

Answer 13

• ECG
• Lipase
• CXR

Question 14

treating acute cholecystisis

Answer 14

• Abx
• IV fluids
• Analgesics

Question 15

What is ERCP used for

Answer 15

diagnosis and treatment of CBD stones

NOT gall bladder stones

Question 16

MRCP is used for

Answer 16

Diagnosis of CBD stones

NOT gall bladder stones

Question 17

complications of gallstones related to the GB

Answer 17

• acute cholecystisis
• carcinoma
• perforation
• gallstone ileus

Question 18

complications of gallstones related to the Common bile duct

Answer 18

• obstructive jaundice
• cholangitis
• pancreatitis

Question 19

Systemic complication of ascending cholangitis

Answer 19

Septic shock/bacteremia

Question 20

Charcot’s triad

Answer 20

Jaundice
Fever
RUQ

Question 21

Raynaud’s pentad

Answer 21

- jaundice
fever
RUQ
hypotensive
confusion

Question 22

IN acute pancreatitis what function of the pancreas are we referring to?

Answer 22

Exocrine functions

Question 23

Prognosis in Acute Pancreatitis

Answer 23

3-5% mortality

Question 24

2 most common causes of pancreatitis

Answer 24

alcohol
gall stones
post- ERCP
- cardiac sx 
CF

Question 25

2 mechanisms for drug-induced pancreatitis

Answer 25

• immunolog-mediated allergic reaction
  early onset
• chronic tox metabolite accumulation
• late

Question 26

patient with pancreatitis

Answer 26

leaning forward from retroperitoneal pain

Question 27

Most specific and sensitive test for AP

Answer 27

• lipase!

Question 28

Systemic effects associated with pancreatitis

Answer 28

- capillaries/vein 
coagulation pathways
white cells
blood vessels 
DIC

Question 29

Imaging findings in acute pancreatitis

Answer 29

colon cut off sign

Question 30

Most common form of organ failure from pancreas is

Answer 30

Renal

Question 31

Treament of pancreatitis is

Answer 31

Fluids
pain relief 
respiratory support
nutrition
ERCP