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Gastro > Biliary Tract Disease > Flashcards

Biliary Tract Disease Flashcards

1
Q

What 5 things can gallstones cause

A 
Colic
Cholecystitis
Jaundice
Pancreatitis (can be fatal)
Bowel Obstruction (unusual)
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2
Q

Why is there more chance of getting gall stones as you get older

A

The level of cholesterol in the body increases

bile gets stickier so it is more likely to become grit like

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3
Q

What are the most common type of gall stones

A

Mixed stones

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4
Q

What is the rarest type of gall stones

A

Primary bile duct stones

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5
Q

What are the other 2 types of gall stones

A

Cholesterol or pigment stones

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6
Q

What are the 5 Fs for gallstones

A 
Forty or fifty
Female
Fat 
Fertile 
Fair ethnicity
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7
Q

What are the symptoms of biliary colic

A 
Stone impacts in the cystic duct
Gradual build up pain in RUQ
Radiates to back/ shoulder
May last 2-6 hours
Associated with indigestion / nausea
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8
Q

What are 5 causes of severe acute epigastric pain

A 
Biliary colic
Peptic ulcer disease
Oesophageal spasm 
Myocardial infarction
Acute pancreatitis
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9
Q

How does acute cholecystitis occur

A

Inflammation in the gall bladder
Obstruction of cystic duct
Initially sterile then becomes infected

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10
Q

Why would you see kidney stones but not gall stones on an x ray

A

Kidney stones contain calcium and the gall stones don’t

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11
Q

What are 5 different diagnostic tools of gallstones

A 
Ultrasound
CT scan
MRCP / ERCP
HIDA
EUS
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12
Q

What is the treatment of acute cholecystitis

A

IV antibiotics
IV fluids
NBM
US to confirm

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13
Q

What is the preferred option of acute cholecystitis

A

Urgent cholecystectomy

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14
Q

What might we do for more elderly patients that are frail and unfit

A

Interval cholecystectomy

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15
Q

What is a major complication of laparoscopic cholecystectomy

A

Bile duct injury

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16
Q

What happens when the stones migrate into the common bile duct

A

Jaundice (if blocking)
Infection of bile duct (cholangitis)
Acute pancreatitis

17
Q

What are the 2 main causes of acute pancreatitis

A

Alcohol or gallstones

18
Q

What is the best treatment for acute pancreatitis

A

Remove the gall bladder to prevent any future stones sticking and causing pancreatitis again

19
Q

What is Gallstone ileus

A

gallstone impacted in the distal ileum causing a Small bowel obstruction

20
Q

Who is most likely to develop a gallstone ileus

A

Elderly females

21
Q

Do all gallstones cause symptoms

A

No

22
Q

What is the single best test for gall stones?

A

Ultrasonography to tell us whether there are gall stones or not and where they are

23
Q

Do we always remove gallstones?

A

No

Only if they are symptomatic or causing complications

24
Q

What is cholangiocarcinoma

A

Bile duct cancer

25
Q

How common is cholangiocarcinoma

A

1 in every 100,000

26
Q

Where is the most common site of cholangiocarcinoma

A

Perihilar

27
Q

When do cholangiocarcinoma present

A

Late

28
Q

What are the common symptoms of cholangiocarcinoma

A

Jaundice
Weight loss
anorexia
lethargy

29
Q

What are 2 complications of cholangiocarcinoma by the time the patient presents

A

Metastases to the lymph nodes or peritoneal

30
Q

What is the most common type of care for cholangiocarcinoma

A

Palliative

31
Q

What 3 diagnositic tests are used for staging or assessment of cholangiocarcinoma

A

Suplex ulstrasound
MRI
Spiral CT

32
Q

How many types of cholanguicarcinoma

A

4

33
Q

What can we do for a patient that has not got metastatic disease

A

Surgery to create a new bile duct

34
Q

What is the prognosis of cholangiocarcinoma with surgery

A

50% survival after 5 years

35
Q

What is a treatment for cholangicarcinoma that has spread and why do we do this?

A

Biliary stent to relieve symptoms

Gastro (67 decks)

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