Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastro Review > Biliary tract@ > Flashcards

Biliary tract@ Flashcards

1
Q

Anechoic cystic lesion that communicate with biliary tract with which CD cyst?

A

Type 1 CD cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diverticula of CBDwhich which CD cyst?

A

Type 2 CD cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intraduodenal and PBJ cyst

A

Type 3 CD cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Both intra and extrahepatic dilation with which CD cyst?

A

Type 4 CD cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Saccular or fusiform dilation without extrahep dilation withwhich CD cyst?

A

Type 5 CD cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is next step for mgmt once dz PB maljcn?

A

Cholecystectomy bc 42% risk of CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which med protects against gallstones?

A

Statins after 12-18 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name meds that inc gallstones.

A

Ceftriaxone, fibrates octreotide, estrogen (CEFO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What percent of pts get gallstones after gastric bypass and what % sxatic?

A

30% get stones at 6 months; about 10% get sxs from it (1/3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Bouverets syndrome’?

A

GD obstruction from impacted gallstone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: Tx of Bouverets syndrome includes attempted GS removal and fistula repair.

A

False, removal only, fistula usu closes on its own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What biliary dz AW AIDS and how to tx?

A

AIDS related cholangiopathy w papillary stenosis - tx with ERCP and sphincterotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are CCA RFs?

A

PSC, bile duct cysts, hepatolithiasis, thorotrast toxin, hep viruses, choledocho, DM, smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which parasites AW CCA?

A

Clonorchis sinensis and opisthorchis viverrini

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

WHat bug causes typhoid fever?

A

Salmonella typhi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who and where is chronic S typhi carriage?

A

In gallbladder on gallstones - biofilm formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How to tx chronic S typhi?

A

Cholecystectomy, no role for abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: Chronic S typhi inc risk of GB CA.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which factors exlude ampullectomy in adenoma?

A

Size > 3-4 cm, +LNs, tumor ingrowth/CA, preference for surg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Best mgmt of early stage hilar CCA?

A

Neoadj chemo, brachytherapy, followed by liver TP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Best tx of CCA in pts who cannot get liver TP or have advanced dz?

A

Gemcitabine and cisplatin chemotx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Up to what % of pts with CCA wont have high CA 19-9?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

New dominant stricture in PSC and polysomy on FISH but neg brushings. What do next?

A

Repeat ERCP with brushings in 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the MC type of GB polyp?

A

Cholestrol (60%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CRC risk in UC vs PSC+UC?

A

combo = 4x higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Carolis syndrome?

A

Carolis dz + cong hepatic fibrosis leading to PoHTN, sponge kidney, cortical cysts, PCKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is Carolis dz?

A

Biliary tree with extensive fusiform and saccular dilations of the intrahepatic ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which PFIC types present as very young child and which as young adult?

A

Child - 1&2

YA - 3

29
Q

Which PFIC has elevated GGT?

A

Type 3 only

30
Q

ABCB4 gene mut AW what?

A

PFIC 3

31
Q

What is initial tx of PFIC?

A

Urosdiol

32
Q

What is Rotor syndrome?

A

AR cause of hyperbili (conj) but no other sxs

33
Q

UGT1A1 AW what?

A

Crigler-Najjar

34
Q

C-N has what type of hyperbili?

A

Unconj

35
Q

How to tx C-N I and II?

A

I - liver TP in early life

II - phenobarbital

36
Q

RFs for black pigmented GS

A

hemolysis, cirrhosis, CF, Crohns

37
Q

RFs for brown pig GS

A

biliary stasis (stricture/infxn)

38
Q

RFs for cholesterol GS?

A

Obesity, female, rapid wt loss

39
Q

Which is radiopaqu and radiolucent - black and brown pig GS?

A

Lucent - Brown

Paque - black

40
Q

Alagilles mutations

A

JAG1 (95%)

NOTCH2 (5%)

41
Q

ATP7B

A

Wilsons dz

42
Q

UGT1A1

A

Gilberts/C-N

43
Q

What is type III CD cyst?

A

Choledochocele - cystic dilation of intra-duodenal portion of CBD

44
Q

MC complication of choledochocele?

A

Pancreatitis

45
Q

Which type of CD cysts have low MAL potential?

A

Types II and III

46
Q

Risk of developing sxs in pts with ascatic gallstones?

A

20% in 20 yrs

47
Q

Once pt with GS gets colic, what is likelihood of recurrence?

A

10-30% at 5 yrs

48
Q

Risk of complicatiosn after developed bil colic if no surg?

A

2%/yr

49
Q

FAP screening for amp CA

A

start age 25-30, do fd & sd viewer - follow up based on Spiegelman stage - if no abnormalities, repeat in 4 years

50
Q

What is Oriental cholangiohepatitis?

A

Recurrent pyogenic cholangitis - will see intrahepatic stones and dilation (Ca bilirubinate stones)

51
Q

T/F: Adenomyomatosis is considered a premalignant GB polyp

A

False, non cancerous

52
Q

How do adenomyomatosis polyps present?

A

Solitary polyp 1-2 cm in size

53
Q

What is Carolis syndrome?

A

Combo of Carolis dz (saccular and fusiform intrahepatic dilation) + cong hepatic fibrosis & PoHTN

54
Q

What is the quickest that PSC TP pt can re-develop PSC?

A

3 months, before that think more of HAT

55
Q

Which pt factors predict nonresponse to UDCA in PBC?

A

sxs at dx, male gender, younger age at dx

56
Q

How to distinguish PFIC type III from the rest?

A

Diagnosed after childhood, elevated GGT, ABCB4 gene mutation, ductular proliferation on bx

57
Q

Black and brown stones comprised of what? As opposed to MC stones which are Cholesterol.

A

Calcium bilirubinate

58
Q

What is the MC complication of choledochocele?

A

Pancreatitis

59
Q

What is a choledochocele?

A

Type III CD cyst

60
Q

Which CD cysts have low MAL potential?

A

Type II and III

61
Q

T/F: Small duct PSC has a better prognosis than large duct.

A

True

62
Q

What is the tx of biliary cystadenoma?

A

Resection due to CA risk with it (20%)

63
Q

Which organism MC related to AIDS cholangiopathy?

A

Cryptosporidia

64
Q

Tx of SOD based on type?

A

Type 1 - sphincterotomy
Type 2 - mano and if +, sphincterotomy
Type 3 - tx like functional pain bc of high risk of panc following sphincterotomy/ERCP

65
Q

Rome III criteria for SOD?

A 
Pain lasting > 30 minutes
Not better with BM or postural changes
Epi or RUQ pain
Recurs but not daily pain
Alters life or ED visits when gets pain
Builds to steady level
No other cause of pain
66
Q

Tx of anastomotic stricture?

A

Plastic or FCMS every 3 months

67
Q

With BD leak after chole, which location is most serious and least likely to resolve with stenting?

A

Main bile duct (type E)

68
Q

What is best tx for early stage unresectable hilar adenocarcinoma?

A

Chemo/rads followed by liver TP. Should use 5-FU, Ext beam rads, brachytherapy, iridium-192 beads; maint with capecitabine

Gastro Review (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions