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IPE Sticky Subjects > Biliary Disease > Flashcards

Biliary Disease Flashcards

1
Q

How do you differentiate biliary colic from acute cholecystitis?

A

DOES NOT INCLUDE FEVER/RAISED WCC/LOCAL PERITONISM

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2
Q

Investigations in Biliary colic (5, bloods all count as 1)

A 
Urinalysis
CXR
ECG
Ultrasound
Bloods (LFTs, INR, FBC)
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3
Q

How to manage biliary colic?

A

Cholecystectomy

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4
Q

Key symptoms of chronic cholecystitis?

A 
RUQ Pain
Nausea
Vomiting 
Fat intolerance
IBS
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5
Q

Investigation for chronic cholecystits?

A

USS

MRCP

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6
Q

Three risk factors for acute cholecystiits?

A

Gallstones, Obesity, rapid weight los

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7
Q

What is Murphy’s sign?

A

Murphy’s sign - Two fingers on RUQ and ask patient to take deep breath in. Pain & arrest of inspiration is positive.

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8
Q

4 investigations for acute cholecystitis?

A 
FBC
LFTs
Ultrasound
HIDA cholescintigraphy
MRCP
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9
Q

Management acute cholecystitis?

A

Cholecystectom

Laparotomy Cholecystectomy

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10
Q

What are 5 symptoms of ascending cholangitis?

A 
Reynold’s Pentad
RUQ pain
Fever
Jaundice
Hypotension
Confusion
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11
Q

Three bacteria which cause ascending cholangitis

A

Klebsiella spp., Escherichia coli, Enterobacter spp

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12
Q

Blood tests for ascending cholangitis (5)

A 
FBC (raised WCC) 
ESR & CRP
LFTs
U&Es
Amylase
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13
Q

Imaging for ascending cholangitis (3)

A

Ultrasound
Abdominal x-ray
Contrast enhanced CT

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14
Q

What is primary biliary cirrhosis? (which bit of liver does it effect?)

A

Autoimmune disorder of biliary system involving destruction of canals of Hering (interlobular bile ducts). Causes intrahepatic cholestasis.

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15
Q

Give four core symptoms of PBC

A

Fatigue
Pruritius
RUQ
Jaundice later

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16
Q

What are 3 signs of PBC

A 
Hepatomegaly occurs in 25%.
Hyperpigmentation occurs in 25%.
Splenomegaly occurs in 15%.
Jaundice occurs in 10%.
Xanthelasma may occur in the later stages.
17
Q

What core super important antibody is involved in PBC?

A

Antimitochondrial antibody

18
Q

What tests would you do in PBC other than antibody screening?

A 
LFTs
IGM
Ultrasound
Cholangiography
Liver biopsy
19
Q

Two possible treatment for PBC

A

Symptomatic - cholestyramine for pruritus

Liver transplant

20
Q

What autoimmune conditions are associated with PBC?

A

Coeliac’s
CREST
Thyroid

21
Q

What is primary sclerosing cholangitis associated with

A

Inflammatory bowel disease!¬

22
Q

What part of the liver does primary sclerosing cholangitis effect?

A

Intra- and extra- hepatic bile ducts

23
Q

Give four key symptoms of PSC

A

Pruritis
Jaundice
RUQ pain
Fatigue, weight loss, shivers

24
Q

What is raised in PSC that isn’t raised in PBC?

A

Alkaline phosphatase

25
Q

Investigations for PSC?

A 
LFTs
PTT
IgG & IgM
p-ANCA
MRCP
Liver biopsy
26
Q

Management for PSC?

A 
Pruritis
Cholestyramine/Rifampicin/SSRI
Prevent progression
ADEK supplements
Avoid alcohol

IPE Sticky Subjects (11 decks)

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