12. Gallstones and Surgical Jaundice Flashcards

1
Q

What medication increases the risk of gallstones?

A

Clofibrate

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2
Q

What complications are associated with gallstones?

A
Acute cholecystitis
Post acute cholecystitis
Chronic cholecystitis
Mirizzi syndrome
Gallbladder carcinoma
Gallstone ileus
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3
Q

What is the name given to gallbladder carcinomas on x ray?

A

“porcelain gallbladder”

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4
Q

What are the limitations of ultrasound?

A

Ultrasoundographer
Obese patient
Air

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5
Q

What is the management of acute cholecystitis?

A
Analgesia, fluids
Abdominal ultrasound
IV antibiotics (e.coli present in gallbladder)
Nil PO if vomiting
Laproscopic cholecystectomy
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6
Q

How is a stone in the common bile duct diagnosed?

A

Ultrasound first but MRCP more reliable

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7
Q

How is a stone in the CBD removed?

A

Urgent ERCP and sphincterectomy

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8
Q

What is Murphy’s sign?

A

Acute cholecystitis
Doctor puts their hand right below patient’s ribcage and asks them to breathe in
Diaphragm pushes gallbladder down and patient gasps

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9
Q

What is MRCP?

A

Magnetic Resonance Cholangiopancreatography
MRI of liver, gallbladder, pancreas
IV contrast used

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10
Q

What is ERCP?

A

Endoscopic Retrograde Cholangiopancreatography
Endoscope is passed into duodenum and through papilla
Dye injected and x ray used to visualise ducts
Instruments can be used to remove stones, stent

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11
Q

Why do you not get colic with ascending cholangitis?

A

No smooth muscle in bile duct

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12
Q

Why does ascending cholangitis quickly become septic?

A

Gram negative organisms in bile ducts have LPS, cause gram negative sepsis

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13
Q

What is the treatment for ascending cholangitis?

A

Broad spec antibiotics

ERCP for emergency decompression

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14
Q

What is the treatment for acute pancreatitis?

A

Urgent ERCP and sphincterectomy

Laproscopic cholecystectomy after resolution as high recurrence

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15
Q

What is surgical jaundice?

A

Due to intra or extra hepatic organic obstruction to bile flow

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16
Q

What are the causes of surgical jaundice?

A

Common: bile stones

Malignancy, inflammation, Mirizzi, PSC