hepato biliary

Question 1

What is most common causative agent for ascending cholangitis?

Answer 1

E coli

Question 2

What is Charcot’s triad?

Answer 2

Charcot’s triad:

1. RUQ pain
2. fever
3. jaundice

also consider raised inflammatory markers, hypotension and confusion for ascending cholangitis

Question 3

How do you manage ascending cholangitis?

Answer 3

• IV abx
• ERCP after 24-48 hours to relieve any obstruction

Question 4

When do you go for laparoscopic cholecystectomy if someone is admitted with acute cholecystitis?

Answer 4

NICE recommend early lap chole within one week (alongside IV abx)

Question 5

What is included in the modified glasgow score for pancreatitis severity?

Answer 5

P - paO2 <8

A - age >55

N - neutrophilia >15

C - calcium <2

R - renal function (urea >16)

E - enzymes: LDH >600

A - albumin <32f/L

S - sugar: blood glucose >10