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GIHEP > 25. Gallstones And Jaundice > Flashcards

25. Gallstones And Jaundice Flashcards

1
Q

What is cholecystitis?

A

Inflammation of gallbladder

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2
Q

What is choledocholithiasis?

A

Stone within bile ducts

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3
Q

What is ascending cholangitis?

A

Inflammation of bile duct

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4
Q

What are gallstones?

A

Stones in the gallbladder

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5
Q

What is biliary colic?

A

Symptom of intermittent severe epigastric pain a/w stones in bile duct

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6
Q

What is the aetiology of gallstones?
(7)

  • 10% of adult population affected (F>M = 2:1) *
A
  1. Gender
  2. Obesity (bile supersaturated with cholesterol)
  3. Haemolytic disorders
  4. Diet (higher in Western world)
  5. Meds (Clofibrate)
  6. Age
  7. Fertility
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7
Q

What can gallstones cause IN the gallbladder?

5

A
  1. Acute Cholecystitis
  2. Post acute cholecystitis —> mucocoele, empyema, gangrene, perforation
  3. Chronic Cholecystitis
  4. Mirizzi’s Syndrome: stone in Hartmann’s pouch causing obstructive jaundice
  5. Gallbladder Carcinoma —> porcelain gallbladder
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8
Q

What do gallstones cause IN the CYSTIC DUCT? (Biliary colic)
(5)

A
  1. Intense pain (RUQ or epigastric)
  2. Distinct attacks
  3. Intense
  4. Usually within hours of eating meal
  5. Few abdo signs
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9
Q

What do gallstones cause OUTSIDE the gallbladder? (Gallstone Illeus)
(2)

A
  • Least common and in elderly women
    1. Fistula between gallbladder and duodenum
    2. Presents as sub-acute small bowel obstruction
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10
Q

What is the management and treatment of acute cholecystitis?
(6)

A
  1. Analgesia
  2. Abdo U/S
  3. IV antibiotics —> initially a chemical sterile inflammation
  4. IV fluids
  5. Nil Po (if vomiting)
  6. Laparoscopic Cholecystectomy
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11
Q

What is the management and treatment of biliary colic?

4

A
  1. Analgesia
  2. IV fluids
  3. Abdo U/S
  4. Laparoscopic Cholecystectomy
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12
Q

What is the management and treatment of stones in CBD?

4

A
  1. U/S
  2. MRCP (more reliable)
  3. Requires urgent ERCP and sphincterotomy
  4. Laparoscopic Cholecystectomy
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13
Q

What is the management and treatment of ascending cholangitis?
(4)

A
  1. Charcot’s Triad
  2. IV antibiotics broad-spectrum (E.coli, Klebsiella, Streptococcus faecalis)
  3. IV fluids
  4. Emergency decompression of biliary system with ERCP
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14
Q

What is the management and treatment of acute pancreatitis?
(3)

A
  1. Urgent ERCP
  2. Sphincterotomy
  3. Laparoscopic Cholecystectomy
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15
Q

What is a laparoscopic cholecystectomy?

A

Gallbladder removal through 5-8in long incision or cut in abdo

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16
Q

What do you look for when taking a HISTORY in a gallstone exam?
(5)

A
  1. Site and nature of pain
  2. Associated symptoms
  3. Jaundice
  4. Rigours
  5. Pale stools, dark urine, pruritis
17
Q

What do you look for when performing a PHYSICAL EXAM on a gallstone patient?
(5)

A
  1. Jaundice
  2. Pyrexial
  3. Scratch marks
  4. Murphy’s sign
  5. Pancreatitis
18
Q

What lab studies do you perform on a gallstone patient?

4

A
  1. FBC —> WCC
  2. CRP
  3. LFTs —> Billi, ALP, AST/ALT
  4. Amylase
19
Q

What is surgical jaundice?

A

Jaundice due to intra- or extra-hepatic organic obstruction to biliary outflow

20
Q

What is biliary obstruction?

A

Blockage of any duct that carries bile from liver to gallbladder or from gallbladder to SI

21
Q

What is the comment form of obstruction and the commonest cause?

A

Extraphepatic

Gallstones

22
Q

What are other causes of jaundice?

6

A
  1. Malignancy
  2. Inflammation (pancreatitis)
  3. Merizzi’s Syndrome
  4. Parasites
  5. Primary Sclerosing Cholangitis (PSC)
  6. AIDS-related cholangiopathy

GIHEP (3 decks)

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