Biliary disease & pancreatitis Flashcards
1
Q
epi of gall stones
A
- 10% of pop
- incidence up with age
- cholesterol in west, pigment in east
- genetics most important
2
Q
4 predisposing factors
A
- age
- fam hx/ ethnicity
- gender/hormones - F>M
- obesity
3
Q
reasons age implicated (3)
A
- higher bilary chol
- GB motility goes down
- less sentive to CCK
4
Q
reasons for females
A
- E makes gall bladder static
- pregnancy increases
5
Q
2 reasons related to obesity
A
- lipid metabolism means increased biliary chol. secretion
2. related to rapid weight loss
6
Q
natura Hx of stones
A
20% will require surgery over 20 years
- only surg once Sx emerge
7
Q
3 clinical syndromes related to stones
A
- biliary colic
- acute cholecystitis
- chronic cholecstitis
8
Q
def. biliary colic
A
CONSTANT RUQ pain due to cystic duct obst. and distension of the gall bladder
- sudden upset and lasting up to 24 hrs
- esp. after a big fatty meal
9
Q
3 treatments
A
- rehysdrate
- analgesics
- elective lap. cholecytectomy
10
Q
path of acute cholecyctitis
A
- duct obst.
- GB ischemia and irritation
- secondary infection
11
Q
def, of cholecystitis
A
- same Sx as acute cholic, but:
- pain >24hrs
- Sx of systemic infaction
- murphy sign
- palpable mass in 20%
12
Q
DDx for gall pain
A
- ulcer
- appendidicits
- pancreatitis
- MI
- pneuminia
13
Q
treat of acute chole
A
- IV fluids, anal, ABs
- 75% better without surgery
- ealry surg. can help prevent recurrence and complications
14
Q
def. chronic chole
A
- chronic inflammation of gall bladder due to stones
- GB wall usually thickened
- GB may be small and contracted
- Sx usually long standing colic
15
Q
diagnosis of gall stones
A
- may cause high LFTs and WBC
- ultrasound is main method
- ERCP
- MRCP
