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Year 4 General surgery > Biliary disease > Flashcards

Biliary disease Flashcards

1
Q

what is cholelithiasis

A

gallstones

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2
Q

risk factors for gallstones

A 
female 
fertile 
40/50s 
fat 
DM 
IBD 
rapid weight loss 
oestrogen + OCP
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3
Q

what materials are gallstones made of

A

cholesterol
pigment
mixed

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4
Q

what is biliary colic

A

symptomatic gallstones with cystic duct / CBD obstruction

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5
Q

symptoms of biliary colic

A 
RUQ/epigastric pain +- radiation to right shoulder tip 
comes and goes 
usually after a fatty meal 
worse at night/early morning 
N+V
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6
Q

clinical findings in biliary colic

A

RUQ tenderness

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7
Q

what is Courvoisiers sign

A

palpable GB in context of painless jaundice is unlikely to be gallstones

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8
Q

what is the gold standard imaging for biliary colic

A

USS

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9
Q

management of biliary colic

A

leave alone if asymptomatic
analgesia and antiemetics
consideration for elective cholecystectomy

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10
Q

what is acute cholecystitis

A

stone impaction at the neck of the gallbladder resulting in inflammation of the GB

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11
Q

inflammation is bacterial in acute cholecystitis, true or false

A

false, initially it is sterile then it becomes infectious

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12
Q

symptoms and signs of acute cholecystitis

A

RUQ pain +- radiating to right shoulder tip
fever / ^ WCC
N+V
+- jaundice

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13
Q

what is Murphy’s sign and where is it seen

A

in acute cholecystitis

pressing on the RUQ creates pain on inspiration (provided there is no pain of the LUQ)

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14
Q

imaging for acute cholecystitis

A

USS

MRCP

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15
Q

management of acute cholecystitis

A 
NBM
IV fluids 
analgesia 
IV antibiotics - cefuroxime 
delayed cholecystectomy
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16
Q

what is cholangitis

A

inflammation of the bile ducts usually due to infection

17
Q

what is the name of the triad of symptoms associated with cholangitis

A

Charcot’s triad

18
Q

list the symptoms of Charcot’s triad

A

RUQ pain
fever/rigors/^WCC
Jaundice

19
Q

cholangitis is a medical emergency, true or false

A

true

Need IV antibiotics ASAP

20
Q

list complications of gallstones

A 
cholecystitis 
cholangitis 
pancreatitis 
perforation 
gallstone ileus
21
Q

what is primary biliary cirrhosis PBC

A

autoimmune condition affecting small bile ducts

22
Q

what is primary sclerosing cholangitis

A

autoimmune condition affecting med-large sized bile ducts

23
Q

with which condition is PSC associated

A

UC

24
Q

what is cholangiocarcinoma

A

malignancy of the bile ducts

Year 4 General surgery (14 decks)

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