39&40: GI Problem 2 Flashcards
Involuntary guarding is a sign of ____ when generalised it is ____
Peritonism
Peritonitis
Cholesterol gallstones form in the gall bladder not the bile duct. Why?
- Cholesterol stored in gall bladder
- Abnormal emptying leads to inc. concentration of cholesterol
- Pigmented stones often form in bile duct
What initiates emptying of the gall bladder?
Cholecystokinin
What is an important consequence of cholangitis?
Pancreatitis
What are the components of charcot’s triad?
- Fever
- Jaundice
- RUQ pain
What is the difference between MRCP and ERCP?
MRCP = magnetic resonance cholangiopancreatography, imaging tool
ERCP = endoscopic retrograde cholangiopancreatography, diagnostic and therapeutic, risk of complications
What is involved in ERCP?
- Endoscopic retrograde cholangiopancreatography
- Cannulation of the bile duct and removal of stones with a basket or balloon (used for common bile duct stones)
What is the commonest feature of bile duct obstruction?
Dilated bile duct
Primary biliary cirrhosis affects ____ bile ducts whereas primary sclerosing cholangitis affects ____
PBC - intrahepatic
PSC - intra and extraheptatic
How do you diagnose primary biliary cholangitis?
- High ALP
- +ve mitochondrial antibody
- Liver biopsy
Which conditions are associated with primary biliary cholangitis?
- Dyslipidaemia
- Osteopenia/osteoperosis
- Hypothyroidism
Which conditions are associated with primary sclearosing cholangitis?
- Recurrent infection
- Ulcerative colitis
How do you treat primary biliary cholangitis?
- UDCA (non toxic bile acid)
- NOT curative
- Increases rate of bile flow, inhibits production of toxic bile acids, inhibit apoptosis, inhibit liver immune response
What are the clinical signs/symptoms of a biliary or pancreatic tumour?
- Painless jaundice
- Palpable epigastric mass
- Palpable gall bladder
