Jaundice and Biliary Disorders CIS Flashcards Preview

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Flashcards in Jaundice and Biliary Disorders CIS Deck (25):
1

Gilbert's syndrome

-reduced activity of urine diphosphate glucuronyl transferase
-unconjugated bilirubin

2

Rotor syndrome

-reduced hepatic reuptake of conjugated bilirubin

3

Dubin johnson

-reduced excretory fxn of hepatocytes
-darkly pigmented liver!!

4

pancreatic cancer- sx

painless jaundice!!

5

Cholelithiasis -inc risk?

(gallstones)
-rapid weight loss, indian, diabetes

6

Cholelithasis- dec risk?

-low carb diet, exercise, coffee

7

porcelain gallbladder- risk for?

gallbladder cancer
(usually seen incidentally)

8

emphysematous gallbladder

-bacterial infection with Clostridium perfringens

9

cholecystitis- stone where?

cystic duct!!

10

Choledocholithiasis- stones where?


common bile duct
-risk factor for asc cholangitis!!

11

Asc cholangitis- most common cause?

common bile duct stone (choledocholithiasis)

12

Asc cholangitis- next step?

emergent ERCP!! (endoscopic retrograde cholangiopancreatography)

13

gallbladder- Somatic dysfxn

-T5-7 on right

14

Cholesterolosis

"strawberry gallbladder"
-accum of cholesterol

15

Jaundice- clinically seen when?

bilirubin > 3 mg/dL!!! (normal 0.2-1.2)
-M > F
-caucasian, hispanic > Af Am

16

Gallstones- risk factors

-female
-inc age
-american indians
-obesity
-rapid weightl oss
-DM
-high intake of carbs
-oral contraceptives
(F- Family hx, fair, fat, female, fertile, forty)

17

Gallstones- protective

-low carb diet
-physical activity
-cardioresp fitness
-coffee
-high intake of Mg and polyunsaturated fats
-high fiber diet
-ASA, NSAIDs

18

Acute cholecystitis- US findings

-GB wall thickening, pericholecystic fluid, sonographic murphy sign

19

Acute cholecystitis- complications

-perforation, gangrene, abscess, peritonitis, emphysematous cholecystitis

20

Choledocholithiasis- imaging

(common bile duct stone)
-best seen ERCP or EUS
(complication of ERCP- iatrogenic pancreatitis)
-bile duct diameter > 6 mm!!

21

porcelain GB

-manifestation of chronic cholecystitis
-intramural calcification of GB wall
-dx- abd radiography- incidental calcified lesion!!!
-asymptomatic often
-inc risk of gallbladder carcinoma!!!

22

Asc cholangitis- sx

-Charcot's triad- jaundice, fever, RUQ pain

23

Reynold's pentad

-Charcot's triad + hypotension and confusion
-asc cholangitis!!!

24

Primary Sclerosing Cholangitis- imaging

-ERCP/MRCP- "beads on a string"
-liver bx- "onion skinning"

25

PSC

-men (20-50 yo)
-UC!
-inc risk of cholangiocarcinoma
-smoking- dec risk of UC and PSC
-coffee- dec risk
-HLA-B8 and DR3/4
-ANCA+
-Dx- MRCP or ERCP!!