pancreas bile stuff Flashcards
(24 cards)
what is acute cholecystitis
inflammation of gallbladder
symptoms of acute cholecystitis
sudden sharp pain in RUQ spreading to R shoulder
tenderness
pain on breathing
fever nausea vomiting
NO jaundice
ascending cholangitis
same as acute cholnagitis
infection and inflammation of bile ducts
due to blockage or infection during an ERCP
symptoms of cholangitis
charcots triad
jaundice
fever
RUQ pain
and shock- low BP, confusion and high heart rate
biliary colic
management acute cholangitis
emergency admission and beware of sepsis
ultrasound
CT
MRCP
nil by mouth
iv fluids
blood cultures
ERCP procedure needed
Cholestasis:
blockage to the flow of bile
Choledocholithiasis:
gallstone(s) in the bile duct
Biliary colic:
intermittent right upper quadrant pain caused by gallstones irritating bile ducts
can radiate to interscapular region
associated with nausea and vomiting
Cholecystostomy:
inserting a drain into the gallbladder
Cholecystectomy:
surgical removal of the gallbladder
pancreatitis symptoms
LUQ pain radiates to back. penetrates. increases steadily over 72h
gastroenteritis symptom
colicky, rapid onset pain
diarrhoea
peptic ulcer symptoms
epigastric pain
Nausea and vomiting
Dyspepsia
Eating worsens the pain of gastric ulcers.
pain of duodenal ulcers improves immediately after eating, followed by pain 2-3 hours later.
Bleeding from the ulcer is a common and potentially life-threatening complication.
haematemesis
malaena
Coffee ground vomiting
Fall in haemoglobin on a full blood count
test for H pylori
Stool antigen test
Urea breath test using radiolabelled carbon 13
H. pylori antibody test (blood)
Rapid urease test performed during endoscopy (also known as the CLO test)
need 2 weeks without using a PPI before testing for H. pylori for an accurate result.
H pylori what is
gram-negative aerobic bacteria
causes damage to the epithelial lining, resulting in gastritis, ulcers and an increased risk of stomach cancer
proton pump inhibitor (e.g., omeprazole) plus two antibiotics (e.g., amoxicillin and clarithromycin) for 7 days
primary sclerosing cholangitis
intrahepatic and extrahepatic bile ducts become inflamed and damaged. strictures that obstruct the flow of bile out of the liver and into the intestine
can lead to liver fibrosis and cirrhosis
CAUSE UNCLEAR- genetic and environmental combo
strong association with ulcerative colitis
Male
Aged 30-40
Abdominal pain in the right upper quadrant
Pruritus (itching)
Fatigue
Jaundice
Hepatomegaly
Splenomegaly
Raise alkaline phosphatase (the most notable liver enzyme as with most “obstructive” pathology)
PSC management
ERCP balloon dilatation and stenting of hepatic ducts
colestyramine for symptoms of pruritus Antibiotics are given alongside ERCP to reduce the risk of infection (bacterial cholangitis).
Replacement of fat-soluble vitamins
Monitoring for complications such as cholangiocarcinoma, cirrhosis and oesophageal varices
only curative- liver transplant
primary biliary cholangitis
autoimmune condition where the immune system attacks the small bile ducts in the liver, resulting in obstructive jaundice and liver disease
previously known as primary biliary cirrhosis.
can be asymptomatic
pruritis
fatigue
GI and abdo symptoms
jaundice
pale, greasy stool
dark urine
xanthelasma
Raised cholesterol increases the risk of atherosclerosis and cardiovascular disease.
white woman
40-60
investigations for PBC
Raise alkaline phosphatase (the most notable liver enzyme as with most “obstructive” pathology)
Other liver enzymes and bilirubin are raised later in the disease
Anti mitochondrial antibodies
anti nuclear antibodies
bile acids do what
help with the digestion of fats
treatment PBC
ursodeoxycholic acid
colestyramine
replacment of fat soluble vitamins
Immunosuppression (e.g., with steroids) is considered in some patients
Liver transplant in end-stage liver disease
scurvy
vit C deficiency
anaemia
low platelets
soft swollen haemorrhagic gums
proptosis
