Complications of gallstones

Question 1

Explain the sudden pain of biliary colic

Answer 1

Sudden GS block cystic duct

Question 2

Location of pain in biliary colic

Answer 2

Intermittent RU pain

Question 3

When is pain in biliary colic worse

Answer 3

After meals

Question 4

Is there fever/jaundice in biliary colic

Answer 4

No

Question 5

Murphy’s sign in biliary colic

Answer 5

-ve

Question 6

Surgery for biliary colic

Answer 6

Elective cholecystectomy

Question 7

Acute cholecystitis

Answer 7

GB inflammation

Question 8

Pathology of acute cholecystitis

Answer 8

BD blocked —> bile build up —> inflam

Question 9

Radiation of acute cholecystitis pain from RU quadrant

Answer 9

Right shoulder tip

Question 10

Is there fever in acute cholecystitis

Answer 10

Yes

Question 11

Is there jaundice in acute cholecystitis

Answer 11

No

Question 12

Murphy’s sign in acute cholecystitis

Answer 12

+ve

Question 13

How to manage GB & associated empyema

Answer 13

• surgery + Abx

- drain

Question 14

Ascending cholangitis

Answer 14

BD inflammation

Question 15

Pathophysiology of ascending cholangitis

Answer 15

BD blocked —> inflammation

Question 16

Chariot’s triad of ascending cholangitis

Answer 16

• RU quadrant pain
• fever
• jaundice

Question 17

Blood tests of ascending cholangitis

Answer 17

• +LFT

- CRP

Question 18

What does USS show in ascending cholangitis

Answer 18

Dilated BD

Question 19

What does CT show in ascending cholangitis

Answer 19

Stones

Question 20

When to use MRCP

Answer 20

More details

Question 21

Pathophysiology of GS-pancreatitis

Answer 21

GS moves outta GB —> block pancreatic duct —> inflam

Question 22

Other than N/V/D what symptom is found in GS-pancreatitis

Answer 22

Loss of appetite

Question 23

High amount of this mineral is found in cholangiocarcinoma

Answer 23

Ca2+

Question 24

Triad of symptoms of cholangiocarcinoma

Answer 24

• abdominal pain
• weight loss
• jaundice

Question 25

Courvoisier sign is in

Answer 25

Cholangiocarcinoma

Question 26

Why is ERCP used in cholangiocarcinoma

Answer 26

Visualise & biopsy

Question 27

Pathophysiology of GS ileus

Answer 27

Fistula between GB & bowel —> GS pass & obstruct bowel

Question 28

Other than pain and distension, what two systemic symptoms found in GS ileus

Answer 28

- v | - d

Question 29

Why is XR used in GS ileus

Answer 29

Pneumobilia spotting

Question 30

Cholestasis

Answer 30

Blockage of bile flow

Question 31

Cholelithiasis

Answer 31

Presence of GS

Question 32

Cholidecholithiasis

Answer 32

GS in GB

Question 33

common clinical feature of many biliary diseases

Answer 33

Itching

Question 34

when should you think of primary sclerosing cholangitis

Answer 34

px w/ bowel disease showing evidence of cholestasis (hyperalbuminia, jaundice, raised alkaline phosphatase)