Lesson 2.2 - Biliary Tree Infections

Question 1

cholangitis

Answer 1

Inflammation of the bile duct system

Question 2

what does charcot’s triad describe

Answer 2

triad of symptoms that describe acute bacterial cholangitis

Question 3

symptoms related to charcot’s triad

Answer 3

RUQ pain
Jaundice
Fever

Question 4

charcot’s triad is similar to what

Answer 4

Mirizzi syndrome (obstruction CHD)

Question 5

Medical emergency sono findings (7)

Answer 5

• Hepatic abscess
• Dilation of intrahepatic biliary tree
• Dilated CBD >6mm
• CBD wall thickening
• Stone in distal CBD
• GB wall thickened
• Pneumobilia

Question 6

parasitic infections of biliary tree (4)

Answer 6

fascioliasis
clonorchiasis
opisthorchiasis
ascariasis

Question 7

Symptoms of parasitic infection relate to what? (3)

Answer 7

biliary obstruction
fever
jaundice
abscess

Question 8

sono findings of fascioliasis

Answer 8

hepatomegaly

hilar adenopathy

Question 9

ascariasis

Answer 9

roundworm

Question 10

recurrent pyogenic cholangitis literal meaning

Answer 10

pus forming inflammation of bile duct system

Question 11

what lobe most often affected with recurrent pyogenic cholangitis?

Answer 11

lateral left lobe

Question 12

recurrent pyogenic cholangitis involves

Answer 12

chronic biliary obstruction
stasis
stone formation

Question 13

acute complication of recurrent pyogenic cholangitis

Answer 13

sepsis

Question 14

chronic complication of recurrent pyogenic cholangitis

Answer 14

biliary cirrhosis

cholangiocarcinoma

Question 15

immune related diseases related to biliary tree (2)

Answer 15

Primary and secondary sclerosing cholangitis

Question 16

what is primary sclerosing cholangitis

Answer 16

chronic inflammatory disease of entire biliary tree

Question 17

t/f sclerosing cholangitis more common in men

Answer 17

true

Question 18

what is commonly seen with primary sclerosing cholangitis? (1)

Answer 18

inflammatory bowel disease - colitis

80% of pts

Question 19

T/F

the eitology is not known in primary sclerosing cholangitis, while it is known in secondary

Answer 19

true

Question 20

what is cholangiocarcinoma

Answer 20

malignant growth in one of the ducts that carries bile from liver to small intestine

Question 21

what is the classification based on in cholangiocarcinoma

Answer 21

anatomic location in liver

Question 22

T/F prognosis is good with cholangiocarcinoma

Answer 22

false

Question 23

most common to least common cholangiocarcinoma

Answer 23

60% - Hilar (Klatskin’s tumour)
30% - distal CBD
10% - peripheral

Question 24

location of Klatkins tumour

Answer 24

porta hepatis

Question 25

symptoms of Klatkins tumour (4)

Answer 25

• jaundice
• pruritis (itchy skin)
• increased LFTs
• nodes

Question 26

what is the second most common primary malignancy of liver

Answer 26

intrahepatic cholangiocarcinoma

Question 27

t/f

cholangiocarcinomas are generally hypovascular masses

Answer 27

true

Question 28

how is intrahepatic cholangiocarcinoma differentiated from HCC

Answer 28

presence of ductal obstruction

Question 29

polypoid masses characteristic of

Answer 29

distal cholangiocarcinoma

Question 30

What can cholangiocarcinoma be confused with

Answer 30

mets

Question 31

mets can affect which ducts

Answer 31

intrahepatic and extrahepatic

Question 32

Mets to biliary tree primary sites (3)

Answer 32

breast
colon
melanoma

Question 33

what is the HIDA scan

Answer 33

measures GB ejection fraction/tracks flow of bile from liver to small intestine