Surgical Tut: Gallstones Flashcards Preview

Jason's MD2 Surgery Rotation > Surgical Tut: Gallstones > Flashcards

Flashcards in Surgical Tut: Gallstones Deck (18):
1

how many ppl have gall stones in their life?

20% of population
1 in 4 ppl with asymptomatic gallstones becomes symptomatic

2

asymptomatic gall stones, take out gall bladder? when to take out?

-leave it if asymptomatic
-if symptomatic will likely get repeat in first 3/12, and get 2 more within the year

3

symptoms of biliary colic

RUQ
fatty meal precipitated
may radiate to back
anorexia
nausea/vomiting sometimes

4

how does cholecystitis cause pain?

increase pressure in gall bladder from obstructed neck

5

cholecystitis? describe the symptoms

inflammation: fever
pain is more constant >12 hours

6

how to differentiate between biliary colic and cholecystitis?

did the pain go away at anytime?

7

what kind of inflammation is cholecystitis?

chemical inflammation
can still get fever

8

cholelithiasis complications?

infection - empyema
pancreatitis
mucoceal (builds up)
jaundice

9

stones in the common bile duct two complications?

cholangitis
pancreatitis

10

how is cholangitis fever different from other fevers eg. UTI?

rigours, fever, jaundice

11

ultrasound features of cholelithiasis

ultrasound positive murphy's
thickened wall

12

what CT scan for biliary tree

CT IVC IV cholangiogram

13

when can you not use CT IVC?

if bilirubin levels are >30, as the hepatocytes can take up biliscopin

14

CT IVC vs. MRCP different in imaging?

-CT IVC gives you functional excretional information
-worried about bile leak

15

when is CT-IVC the best test for?

if suspect bile leak

16

do you operate for cholecystitis?

yes, ASAP

17

how to treat cholangitis?

antibiotics
bile duct exploration

18

2 kinds of gall stones?

cholesterol stones
pigmented: calcium: bilirubin break down

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