Biliary CIS

Question 1

how do we visualize the biliary tree?

Answer 1

HIDA scan

Question 2

Giving CCK

Answer 2

to see how much of the radioisotope is excreted by the gall bladder during HIDA scan

35% and above is normal, helpful to see if the gallbladder is working

also, when giving CCK can recreate pain and help with diagnosis

Question 3

thickened gall bladder wall suggests what?

Answer 3

inflammation going on

chronic cholecystitis

Question 4

treatment for chronic cholecystitis

Answer 4

laparoscopic cholecystectomy

Question 5

jaundice means we should think about

Answer 5

liver and biliary tree, rather than gallbladder

Question 6

charcot’s triad is pathognemonic for

Answer 6

RUQ + fever + jaundice

infected biliary tree: ascending cholangitis

Question 7

add hypotension and mental disturbance to charcot’s triad

Answer 7

reynold’s pentad

patient is going into septic shock, will die soon if we don’t do something about it

Question 8

dull aching RUQ pain plus history of Hep C or B makes you think what?

Answer 8

hepatocellular carcinoma

Question 9

a strong indicator of hepatocellular carcinoma

Answer 9

alpha fetoprotein

Question 10

U/S is not very sensitive for biliary tree but quite sens for

Answer 10

gallbladder

Question 11

people with PSC are at high risk for

Answer 11

cholangiocarcinoma

Primary Sclerosing Cholangitis