Acute Abdominal Inflammatory Conditions

Question 1

Upper abdominal inflammatory conditions

Answer 1

Gall stone disease (cholecystitis, cholangitis), pancreatitis, peptic
ulcer disease, gastro-oesophageal reflux disease (GORD)
oesophagitis.

Question 2

Lower abdominal inflammatory conditions

Answer 2

Appendicitis, diverticular disease, inflammatory bowel disease,
Clostridioides (Clostridium) difficile colitis, radiation proctitis.

Question 3

Other name for gall stones

Answer 3

Cholelithiasis

Question 4

How many people get symptoms of gall stones

Answer 4

60-80 % asymptomatic

Question 5

Types of stones

Answer 5

Cholesterol stones
Pigmented
Mixed

Question 6

Pigmented stones suggest

Answer 6

Black- haemolytic/ cirrhosis

Brown- stasis and infection in biliary siystem

Ecoli and klebsiella

Question 7

Biliary colic
Pain
Pain subsides?

Answer 7

Pain when stone obstructs cystic duct

Pain subsides when stone falls back from suspicion duct

Question 8

Biliary colic onset

Answer 8

Sudden

Question 9

Biliary colic lasts how long

Answer 9

1-4 hours

Question 10

Radiating / non radiating

Answer 10

Right scapula

Question 11

Is it obvious from patient they are experiencing biliary colic

Answer 11

Patient doesn’t look unwell

Question 12

What test do we do for inflamed gall bladder

Answer 12

Murphy sign

Question 13

Process of Murphy sign

Answer 13

Hand at costal margin RUQ

Deep inspiration diaphragm moves
down •

Pain when inflamed gallbladder
contacts palpating hand

• Manoevure in LUQ should not elicit
pain

Question 14

Cholangitis classically leads to

Answer 14

Charcots triad

Question 15

Charcots triad

Answer 15

Jaundice fever RUQ pain

Question 16

Gallstone lleus is

Answer 16

Gallstone causing small bowel obstruction

Question 17

What investigation confirms presence of gallstones

Answer 17

USS

Question 18

MRCP does what

Answer 18

Helps visualise biliary tree accurately

Diagnostic non invasive

Question 19

Spyglass does what

Answer 19

Allows visual examine the biliary ducts,
• take biopsy samples and
• treat large biliary stones by either electrohydraulic or laser lithotripsy.

Question 20

Management of GB diseases

Answer 20

Remove the gall bladder

Question 21

Complications of laparoscopic cholecystectomy

Answer 21

Early: bleeding
Bile leak
Damage to common bile duct

Late:

Retained stones
Bile duct structure

Question 22

Aetiology of acute pancreatitis

Answer 22

I GET SMASHED

Question 23

Pathophysiology of acute pancreatitis

Answer 23

May extend to local and distant extrapancreatic tissues

Question 24

Diagnosis of acute pancreatitis

Answer 24

Epigastric pain and vomiting

Serum amylase or lipase

Question 25

Mild pancreatitis

Answer 25

No organ failure

No local or systemic complications

No imaging required

Discharge within one week

75% of cases

Question 26

Moderately severe pancreatitis

Answer 26

Transient organ failure

Local or systemic complications

Discharge within 2/3 weeks

Morality <8%

Question 27

Severe pancreatitis

Answer 27

Persistent organ failure > 48 hours

Infected necrosis

Managed in HDU/ICU

Develops during early phase

Local or systemic complication

Question 28

Clinical scoring system what score is seen as severe AP

Answer 28

More than or equal to 3

Question 29

Peptic ulcers are found where

Answer 29

Both gastric and duodenal ulcers

Question 30

Which PUD are more common

Answer 30

Duodenal

Question 31

Symtomps of PUD are

Answer 31

nonspecific

Epigastric pain 1 to 3 hours

Question 32

Gastro- oesophageal reflux disease (GORD)

Answer 32

Prolonged contact of gastric contents with lower oesophageal mucosa resulting in symptom or complications

Question 33

What grading used for GORD

Answer 33

Salary miller grading