Biliary/Pancreatic Conditions Flashcards Preview

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Flashcards in Biliary/Pancreatic Conditions Deck (22)
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1
Q

What are the 5Fs for risk factors of gallstones?

A

Female - Fat - Fertile (pregnancy) - Fair - Forty

2
Q

What are the 3 categories of gallstones and which is the most common?

A

Mixed (most common), cholesterol and pigment

3
Q

Where can biliary colic radiate to?

A

Upper abdomen, back and shoulder

4
Q

What is the management of biliary colic?

A
  • Pain killers
  • Low fat diet/lose weight if obese
  • Observe 3-6 months
  • Recurrent episodies of pain/colic: cholecystectomy (lap or open)
  • if unfit: ursodeoxycholic acid 10mg/kg/day
5
Q

Cholethiasis

A

Gall stones present

6
Q

Cholestasis

A

Bile can’t flow from liver to duodenum, often due to gallstone

7
Q

Cholecystitis

A

Inflammation of the gallbladder (with or without stones). Initially sterile in the gallbladder, but becomes infected.

8
Q

Cholangitis

A

Infection of the bile duct (if ascending - goes from CBD up to liver)

9
Q

What is the treatment for acute cholecystitis?

A
  • IV antibiotics and IV fluids
  • Nil by mouth
  • US to confirm diagnosis
  • Urgent cholecystectomy (asap)
10
Q

What are some of the complications of gallstones?

A

Jaundice, cholangitis, acute pancreatitis and gallstone ileus

11
Q

What are the causes of pancreatitis?

A

Gallstones
Ethanol
Trauma

Steroids 
Mumps
Autoimmune
Scorpions
Hyperlipidaemia/Hyperthermia/Hypercalcaemia
ERCP
Drugs
12
Q

What is the pathophysiology of acute pancreatitis?

A

Autodigestion of peri-pancreatic tissues by activated enzymes due to bile reflux

13
Q

What is the management for cholangiocarcinoma?

A

Curative: Biliary and liver resection
Palliative: biliary stent

14
Q

What is the pathophysiology of gallstones?

A

Disruption of the balance of the cholesterol and bile salts in the bile (e.g. cholesterol stones result from too much cholesterol, and pigment stones from too much bilirubin from excess haemolysis etc)

15
Q

Cholangiocarcinoma

A

Carcinoma of the bile ducts

16
Q

What is the definitive test for pancreatitis?

A

Amylase

17
Q

What is the management of pancreatitis?

A

Supportive mostly

Surgical: puestow procedure (anastomose pancreatic duct and jejunum) or frey procedure (cored out diseased portions)

18
Q

What is the most common cancer of the exocrine pancreas?

A

Adenocarcinoma

19
Q

Wha is the difference between mild and severe acute pancreatitis?

A

Mild is associated with minimal organ dysfunction, while severe involves complete organ failure, with possible local complications

20
Q

What are the symptoms of pancreatitis?

A
  • Epigastric/diffuse abdominal pain +/- radiation to the back
  • Nausea and vomiting
  • Indigestion
  • Abdominal tenderness
  • Loss of appetite +/- weight loss
  • Temperature
  • Jaundice (pain
21
Q

What score can be used to rate the severity of pancreas?

A
- Glasgow Prognostic Score:
• PaO2  55 years 
• Neutrophils: (WBC >15 x109/l 
• Calcium  16mmol/l)
• Enzymes: (AST/ALT > 200 iu/L or LDH > 600 iu/L)
• Albumin 10mmol/L) 

Any 3 factors means acute severe pancreatitis

22
Q

What are some of the main complications of acute pancreatitis?

A

Pseudocyts, abscesses, nectrosis, ascites, splenic artery aneurysm and pleural effusion