biliary system Flashcards
what is cholelithiasis?
gall stones
risk factors for gall stones?
female, fat, 40, fertile, pregnancy
investigation for gall stones (cholelithiasis)?
abdominal USS, LFTs
treatment for gall stones (cholelithiasis)?
pain relief, lap. cholecystectomy
what is acute cholecystitis?
inflammation of the gall bladder (obstruction can lead to infection/inflammation)
features of acute cholecystitis?
constant RUQ pain, tender, fever, guarding
what is a positive murphys sign and what does it indicate?
hold RUQ and get patient to breath in = pain
indicated acute cholecystitis
how does ascending cholangitis occur?
presence of gall stones in the common bile duct leads to biliary tree obstruction and infection
how does ascending cholangitis present (charcoats triad)?
jaundice, fever, RUQ pain
investigation for ascending cholangitis?
abdominal USS to show stones in common bile duct
treatment for ascending cholangitis?
IV antibiotics and fluids
what is primary biliary cholangitis (cirrhosis)?
autoimmune disease of the bile ducts
auto AMAIgs against M2 mitochondria
middle aged lady complaining of fatigue and itch (no rash)
can lead to osteoporosis, cirrhosis and hepatocellular carcinoma
treatment: vitamin ADEK and urosodeoxycholic acid
what is primary sclerosing cholangitis?
associated with ulcerative colitis RUQ pain, fever, jaundice, itch, fatigue high risk of cholangiocarcinoma affects men>women onion skin fibrosis (bending of bile ducts) diagnosed by ERCP/MRCP
what features are part of charcoats triad and what does they indicate?
fever, jaundice, RUQ pain (charcoats triad)
indicates ascending cholangitis
what does a positive murphys sign indicate?
acute cholecystitis
