choledocholethiasis overview

Question 1

ascending cholAngitis

sx;sign

Answer 1

sx=RUQ or epigastric pain

Dark urine; (hint: ascend=> descending fluid= urine)

signs=Fever + Rigors (bacteremia)

Question 2

ascending cholAngitis/

important tests

Answer 2

imaging:

USound Endoscopic /US

ERCP/ MRCP

CBC (bacteremia) , Blood Cx (bacteremia)

liver: ALT; AST; bilirubin

Question 3

Acute cholecystitis

/important tests

Answer 3

Ultrasound

ck= u r trying to get a baby out

Question 4

Pancreatitis/

risk factors;

Answer 4

risk factors=Alcohol abuse (binging) Gallstones;

Question 5

Pancreatitis/

important test (1)

important imaging (1)

Answer 5

Serum lipase

Ultrasound= try to see the gallstone or any fluid= pseudocyst

Question 6

Hepatitis/

demo;risk factors;sx;sign

Answer 6

risk factors=Alcohol abuse Injection drug use,

sx=RUQ pain + Nausea;

sign:Dark urine

hint=fat is not processed properly=> yuk

Question 7

Hepatitis/important tests

Answer 7

high ALT + AST

Viral serologies

Question 8

Acute Cholecystitis/

presentation

Answer 8

1. persistent RUQ or epigastric pain;
2. fever;
3. NV; 65% +
4. murphy sign

hint: nausea bec fat is not processed properly

Question 9

Acute Cholecystitis/

tx

Answer 9

hospital admission;

parenteral antibiotics;

+cholecystectomy.

Question 10

Acute Pancreatitis/

presentation: 9 criteria of cc

Answer 10

T :constant and boring

Q=moderate to severe intensity that develops in the

R=epigastrium +

R:radiate to the back. /

Worse: supine. ck: better assis or leaning forward

Ass.sx :NV; low-grade fever (itis)

hint: itis=> inflammation already there=> constant

Question 11

Acute Pancreatitis/

rare but famous signs

Answer 11

Periumbilical bruising (Cullen sign)

/flank bruising (Grey Turner sign);due to Retroperitoneal bleeding from pancreatitis (or AAA etc)

hint: umbilicus=== cul=> cullen

flank= squeez=> turn

Question 12

**Acute Pancreatitis/

rx ass. w pancreatitis

Answer 12

GU:estrogens

GU: furosemide; hydrochlorothiazide=HTZ ;

Abx:metronidazole; tetracycline,sulfonamides;

corticosteroids;

opioids;

psych: valproate

Question 13

Acute Pancreatitis/

severe and fatal complication: %

Answer 13

20%

Question 14

Acute Pancreatitis/

local complications

Answer 14

Pancreatic pseudocyst

Pancreatic necrosis

Infections/

infection of the previous 2

pseudocyst infected= abcsesse/ ascending cholAngitis

Question 15

**Acute Pancreatitis/

systemic complications

Answer 15

Hyperglycemia (— insulin)

Hypocalcemia

lung: Acute respiratory distress syndrome =ARDS

GU: Acute kidney injury

blood: Disseminated intravascular coagulation=DIC

Question 16

pancreatitis + death/ when does that occur?

Answer 16

pts w infected pancreatic necrosis or w multiple organ dysfxn