Biliary Tree and Pancreas

Question 1

What is the pathophysiology of cholesterol stones?

Answer 1

Imbalance of ratio of cholesterol to bile salts disrupting micelle formation
Risk factors are those for cholesterol excess in bile, e.g. female, obesity, diabetes, genetics

Question 2

What is the brief pathophysiology of pigment stones?

Answer 2

Excess bilirubin due to haemolysis, e.g. in haemolytic anaemia

Question 3

What cancer is most commonly found in the gall bladder?

What is it associated with?

Answer 3

Adenocarcinoma

Gallstones

Question 4

What is the most common cholangiocarcinoma?
(Cancer in bile ducts)
What conditions is it associated with?
What does it present with?

Answer 4

Adenocarcinoma
UC and primary sclerosing cholangitis
Obstructive jaundice

Question 5

What are some common aetiologies of acute pancreatitis?

Answer 5

Bile reflux
Duct obstruction due to stone damage to sphincter of Oddi
Alcohol
Shock
Trauma
Hyperparathyroidism

Question 6

What are some common aetiologies of chronic pancreatitis?

Answer 6

Alcohol
Gallstones
CF
Hyperparathyroidism 
Familial

Question 7

What is the most common cancer of the pancreas?

What is it associated with?

Answer 7

Adenocarcinoma

Smoking, diabetes, familial pancreatitis