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7- Surgery > Surgical Jaundice > Flashcards

Surgical Jaundice Flashcards

(47 cards)

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1
Q

What is surgical jaundice

A

Any jaundice amenable / correctable by surgical intervention

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2
Q

Main cause of surgical jaundice

A

Extrahepatic biliary obstruction

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3
Q

What are some congenital dx of gallbladder and bile ducts leading to surgical jaundice

A

Extrahepatic biliary atresia
Choledochal cyst
Cholelithiasis

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4
Q

What is biliary atresia

A

Abnormal narrowing of common Bile duct or left hepatic duct

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5
Q

Clinical feature of biliary atresia

A

Jaundice at birth or by end of first week and deepens later
Bile stained méconium
Pale stool
Dark urine
Pruritus
Clubbing
Skin xanthomas

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6
Q

What is choledochal cyst

A

Congenital dilatations of intra / Extrahepatic biliary system

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7
Q

Symptoms and signs of choledochal cyst

A

Jaundice
Fever
BDOMINAL PAIN
RIGHT upper quadrant mass

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8
Q

Investigation choledochal cyst

A

Ultrasonography
MRI
Ct scan

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9
Q

Treatment of choledochal cyst

A

Radical excision of the cyst and reconstruction of biliary tract

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10
Q

Most common biliary pathology leading to surgical jaundice

A

Cholelithiasis

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11
Q

3 types of gallston3s

A

Cholesterol stones
Pigment stones ( brown or black. )
Mixed stones

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12
Q

Cholelithiasis risk factors

A

Obesity
High calorie diet
Abnormal gastric emptying

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13
Q

Components of black pigment stone in Cholelithiasis

A

Insoluble bilirubin
Pigment polymer
Calcium phosphatase and calcium carbonate

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14
Q

Main causes of black pigment stone

A

Hemolytic disease like Hereditary spherocytosis or sickle cell anemia

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15
Q

Component of brown pigment stones

A

Calcium bilirubinate
Calcium palmitate
Calcium stearate
Cholesterol

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16
Q

Causes of brown pigment

A

Bile stasis
infected bile

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17
Q

Clinical features of gallstone

A

Right upper quadrant or epigastric pain

Dyspepsia
flatulence
food intolerance fatty food
altered bowel habits

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18
Q

Common differential diagnosis of Cholelithiasis

A

Acute appendicitis
perforated gastric ulcer
Acute pancreatitis

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19
Q

Complication of gallstones

Study These Flashcards
A

Biliary colic
acute cholecystitis
Chronic cholecystitis
Empyema of gallbladder
Mucocele
biliary obstruction
acute cholangitis
acute pancreatitis
intestinal obstruction
gallstone Ileus

20
Q

What Is cholecystitis

Study These Flashcards
A

Inflammation of the gallbladder occurring mostly during obstruction of cystic duct from cholelithiasis

21
Q

Risk factors of calculus cholecystitis

Study These Flashcards
A

Increasing age
obesity
drugs
pregnancy

22
Q

Risk factor associated with acalculous cholecystitis

Study These Flashcards
A

Biliary stasis
debilitation
major surgery
severe trauma
sepsis
long-term total parenteral nutrition
prolonged fasting
diabetes mellitus

23
Q

Clinical features of acute cholecystitis

Study These Flashcards
A

Acute upper abdominal pain starting in the epigastric region and going to the right upper quadrant which may radiate to shoulder , colicky
fever
Tachycardia
guarding
rebound tenderness
jaundice not common

24
Q

Complications of acute cholecystitis

Study These Flashcards
A

Perforation
gangrene
peritonitis

25
What Is cholangitis
Infection of the biliary tract
26
Clinical presentation of cholangitis
Jaundice right upper quadrant pain fever with chills and Rigor
27
What is sclerosing cholangitis
Idiopathic fibrosing inflammatory condition. Of the biliary tree affecting intra and extra hepatic ducts
28
Risk factor of sclerosing cholangitis
Inflammatory bowel disease - UC Hypergammaglobulinaemia
29
Clinical presentation of sclerosing cholangitis
RUQ discomfort Jaundice Pruritus Weight loss Fever ‘Fatigue
30
Investigations in idiopathic cholangitis
LFT Ultrasonography Cholangiography ERCP
31
Treatment of idiopathic cholangitis
Vit K Steroids Immunosuppressants Endoscopic stenting
32
Causes of stricture of bile duct
Congenital in biliary atresia Bile duct injury during surgery Inflammation ( stones, cholangitis , pancreatitis , sclerosing cholangitis ) Trauma Idiopathic
33
Main benign tumors of the bile duct
Papilloma Adenoma
34
Main malignancy tumor of biliary duct
Adenocarcinoma
35
Clinical features of malignant tumors of biliary tree
Jaundice Abdominal pain Early satiety Weight loss
36
Investigation of tumors of biliary tree
Biochemical - bilirubin high , high phosphatase , high GG transaminase Tumor marker - CA 19-9 Ultrasonography Percutaneous transhepatic cholangiography Percutaneous drainage for cytology
37
Treatment of tumor of biliary tree
Resection
38
Prognosis of biliary tree tumor
18 months medians survival with 20% S5y
39
Form of bilirubin elevted in prehepatic jaundice
Unconjugated bilirubin
40
Form of bilirubin elevated in hepatic jaundice
Both conjugated and Unconjugated
41
Form of bilirubin elevated in post hepatic jaundice
Conjugated
42
Urine color in different form of jaundice
Pre hepatic - normal Hepatic / post hepatic - dark
43
Stool color in different form of jaundice
Pre hepatic / hepatic - normal Post hepatic - steatorrhea
44
Pruritus presence in different form of jaundice
Pre hepatic / hepatic - not present Post hepatic - present
45
What is Gilbert’s syndrome
Hereditary conditions with mild jaundice due to low levels of bilirubin processin enzymes in the liver
46
Investigation in obstructive jaundice
FBC Electrolytes, urea, creat LFT Bilirubin Urinalysis - bilirubin , urobilinogen Faecal occult blood test Coagulation profile Hepatitis serology
47
Imaging of choice in obstructive jaundice
Magnetic resonance cholangiopancreatography MRCP

7- Surgery (13 decks)

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