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Robbins Pathology GI (Chptr 16,17,18,19) > Clinical- Billiary And Jaundice Disorders > Flashcards

Clinical- Billiary And Jaundice Disorders Flashcards

(45 cards)

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1
Q

How does biliary dyskinesia present

A
  • Right upper quadrant pain
  • Severe pain that limits daily life
  • Nausea with episodes of pain
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2
Q

Which tests should be done on a patient before performing an ERCP

A
  • measure INR (clotting factors)
  • Pregnancy test
  • Kidney function (if using dye)
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3
Q

How is biliary dyskinesia diagnosed

A

Right upper quadrant pains (similar to biliary colic)

-Diagnosed with a normal ultrasounds of the gallbladder

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4
Q

If we get a GGT (gamma glutamyl transferase), and it is elevated, what is the most likely source of the jaundice

A

The liver source

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5
Q

What is the diagnostic test finding on ultrasound to indicate gallstones

A

Acoustic shadowing

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6
Q

What is the cause of choledocholithiasis

A

Stones in the bile duct

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7
Q

What is charcot triad an indication for

A

Ascending cholangitis

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8
Q

What is Murphys sign

A

Deep inspiration or coughing during inspiration in the RUQ produces pain or inspiration arrest

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9
Q

What are signs of choledocholithiasis

A
  • frequent attacks of RUQ pain persisting for hours
  • chills and fever with pain
  • history of jaundice and ab pain
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10
Q

What is the only hyperbilirubinemia associated with unconjugated bilirubin

A

Gilbert syndrome

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11
Q

What is considered to be an abnormal ejection fraction of a HIDA (hepatic iminodiacetic acid) scan

A

Less than 35-38% —> cholecystectomy

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12
Q

What are the suggestive findings of acute cholecystitis on ultrasoundography

A
  • Gallbladder wall thickening
  • pericholecystic fluid
  • sonography Murphys sign
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13
Q

What can choledocholithiasis lead to

A

Acute ascending cholangitis (AC)

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14
Q

What condition is associated with primary sclerosing cholangitis

A

UC

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15
Q

What is the most reliable detection of stones in the bile duct

A

ERCP or EUS

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16
Q

What is the method used to look for an obstructive jaundice

A

Aka conjugated jaundice

-Ultrasonography followed by a cholangiography

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17
Q

What is the procedure of choice for choledocholithiasis

A

ERCP with sphincterotomy and stone extraction, or a stent placement

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18
Q

What are the labs associated with primary sclerosing cholangitis

A

Elevated alkaline phosphatase, GGT

-p-ANCA antibodies

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19
Q

What constitutes Charcot triad

Study These Flashcards
A
  • RUQ pain
  • Fever chills
  • Jaundice
20
Q

What does Raynaud pentad signify

Study These Flashcards
A

Acute suppurative cholangitis and a medical emergency

21
Q

What are the imaging findings in primary sclerosing cholangitis

Study These Flashcards
A

“Beads on a string”

“Onion skin”

22
Q

What is Reynold pentad

Study These Flashcards
A
  • Fever/chills
  • RUQ pain
  • jaundice
  • Altered mental status
  • hypotension
23
Q

What is biliary colic

Study These Flashcards
A

-Severe steady ache in the RUQ or epigastric, can radiate the back scapula

24
Q

What is the serology finding in primary biliary cirrhosis

25
What is the best diagnostic test for gallstones
Ultrasonography
26
What is a a HIDA scan and what is being looked at
Radionucletide scan, where the gall bladder should be visualized within an hour if normal
27
What is a common reason to have slightly elevated aminotransferase levels (ALT and AST)
Nonalcoholic fatty liver disease
28
What are the complications of acute cholecystitis
- Gangrene of the gall bladder (splanchnic vasoconstriction) - perforation with formation of a pericholecystic abcess - occasionally generalized periodonitis - Emphysematous cholecystitis (secondary infection with gas forming bacteria) - empyema
29
What are the complications associated with endoscopic retrograde cholangiopancreatography
Pancreatitis, bleeding, infections, perforations
30
What is the cause of over 90% of cases of acute cholecystitis
Gallstones in the cystic duct
31
What is an abnormal HIDA scan and what is the diagnosis
If the gallbladder is not seen within an hour, then abnormal due to stone in cystic duct or cholecystitis
32
What are the lab findings indicative of choledocholithiasis
- Huge increase in ALT/AST - Alkaline phosphate and GGT rise - serum amylase if secondary pancreatitis
33
What are the complications associated with Primary sclerosing cholangitis
Osteoporosis and vitamin absorption | Cholangiocarcinoma
34
What is the prognosis in a patient with porcelain gallbladder
Poor, as indicated calcification and increased risk of gallbladder cancer
35
Increased amounts of unconjugated bilirubin is usually due to what
Increased bilirubin production as a result of hemolytic reactions or impaired uptake of bilirubin
36
What not gallbladder related complication is associated with courvoisiers sign
Pancreatic cancer of the head
37
What condition is common if fasting increases the amount of bilirubin in the blood
Gilbert’s syndrome
38
What is the xray finding in a patient with chronic cholecystitis
Porcelain gallbladder
39
What are the protective factors against gallstones
- Low carb - Physical activity (cardiorespiratory fitness) - caffeine in women - High Mg intake - High fiber and statin diet - ASA and NSAIDs
40
What is the increased risk associated with primary sclerosing cholangitis
Cholangiocarcinoma
41
What is biliary dyskinesia and what is the common cause
Symptomatic functional disorder of the gallbladder with an unknown etiology
42
Which normally bad habit decreases the risk of UC and PSC
Smoking
43
Which patient population is prone to pigmented stone
Asian Americans
44
What are the lab results that accompany a biliary dyskinesia
Normal liver enzymes, conjugated bilirubin, and amylase/lipase
45
If we get a GGT (gamma glutamyl transferase) and the levels are normal, what is the likely source
Bone or other growing source (placenta)

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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