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AY Gastrointestinal > Billiary & Pancreatic Disease > Flashcards

Billiary & Pancreatic Disease Flashcards

1
Q

Why do we get gallstones?

A 
Abnormal bile composition 
Bile stasis 
Infection 
Excess cholesterol 
Excess bilirubin
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2
Q

What are the categories of gallstones?

A

Mixed
Cholesterol
Pigment
Primary bile duct stones

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3
Q

Risk factors for gallstones

A 
Age > 40 
Female 
High fat diet 
Obesity 
Pregnancy 
Hyperlipidaemia 
Bile salt loss (Crohn's) 
Diabetes
Dysmotility of GB
Prolonged fasting 
TPN
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4
Q

What are the 5 F’s of gallstone risk factors?

A 
Fair 
Fat 
Female
Fertile
Forty
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5
Q

Symptoms of gallstones

A 
Biliary colic 
Pain after eating fatty meal 
Pain increases on inspiration 
Jaundice & itching 
Tachycardia
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6
Q

What is biliary colic?

A

Pain as gallstone impacts on cystic duct
Radiates to back/shoulder
Especially after fatty meal

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7
Q

Causes of severe acute abdominal pain

A 
Biliary colic 
Peptic ulcer
Oesophageal spasm 
MI
Acute pancreatitis
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8
Q

What is acute cholecystitis?

A

Inflammation of gallbladder causing obstruction of cystic duct
Becomes infected

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9
Q

Investigations for gallstones

A

Ultrasound
Ct scan
MRCP/ERCP

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10
Q

Treatment of gallstones

A

Depends on affect they are having on patients life
Keyhole surgery

Usodeoxycholic acid

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11
Q

Complications of gallstones

A 
Jaundice 
Cholangitis 
Acute pancreatitis 
Gallstone ileus 
Carcinoma
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12
Q

What is the best investigation for CBD pathology?

A

MRCP

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13
Q

What procedure is used to remove gallstones?

A

ERCP

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14
Q

Causes of pancreatitis

A

G - gallstones
E - ethanol
T - trauma

S - steroids 
M - mumps 
A - autoimmune 
S - scorpion/spider bites 
H - hyperlipidaemia/hypercalcaemia 
E - ERCP
D - drugs
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15
Q

What is a gallstone ileus?

A

Small bowel obstruction as gallstone impacted in distal ileum
Passes through fistula between gallbladder and duodenum

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16
Q

Treatment of gallstone ileus?

A

Urgent laparotomy

Interval cholecystectomy in 3 months

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17
Q

Clinical presentation of cholangiocarcinoma

A 
Jaundice 
Weight loss
Anorexia 
Lethargy 
(50% have lymph node metastasis at diagnosis)
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18
Q

Investigations for cholangiocarcinoma

A

Duplex ultrasound
Spiral CT/ ERCP/ PTC
MRI/MRCP

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19
Q

Treatment of cholangiocarcinoma

A 
Surgical resection 
Biliary stent (palliation)
20
Q

3 diseases of the pancreas

A

Acute pancreatitis
Chronic pancreatitis
Pancreatic tumours

21
Q

Imaging for pancreatitis

A 
CXR/AXR
Ultrasound 
Ct scan 
MRI 
ERCP (not diagnostic)
22
Q

Complications of pancreatitis

A 
Fluid collections 
Necrosis 
Ascites
Bleeding 
Abscess 
Sepsis 
Pleural effusion 
Renal failure
23
Q

Symptoms of acute pancreatitis

A 
Diffuse abdominal pain (radiate to back) 
Nausea & vomiting 
Indigestion 
Abdominal tenderness 
Loss of appetite +/- weight loss 
Temperature 
Jaundice
24
Q

Treatment of acute pancreatitis

A

Treat underlying cause of necessary

Nutritional support

25
Q

What is chronic pancreatitis?

A

Progressive and irreversible da,age of pancreatic tissue

Results in permanent loss of endocrine/exocrine function

26
Q

Causes of chronic pancreatitis

A

GET SMASHED

27
Q

Imaging for chronic pancreatitis

A

CXR/AXR
Ultrasound
CT scan
MRI

28
Q

Treatment of pancreatitis

A

Dependent on the cause

29
Q

Treatment of pancreatitis caused by cysts or pseudocysts

A

Endoscopic drainage

30
Q

Treatment of autoimmune pancreatitis

A

Steroids

31
Q

Pancreatitis caused by cancer

A

Pancreatectomy

32
Q

Complications of chronic pancreatitis

A 
Splenic vein thrombosis 
Pseudoaneurysms 
Pancreatic cancer 
Pseudocysts 
Bile duct or duodenal obstruction 
Pancreatic ascites 
Pleural effusion
33
Q

Management of biliary/duodenal obstruction caused by pancreatitis

A

Stent
Bypass
Resection

34
Q

What is the main type of exocrine pancreatic carcinoma?

A

Adenocarcinoma

35
Q

Where are adenocarcinomas of the pancreas located?

A

Pancreatic head, body or tail

36
Q

What are the types of endocrine pancreatic cancer?

A

Gastrinoma
Insulinoma
Glucagonoma

37
Q

What is the effect of gastrinoma?

A

Produces gastrin causing increased stomach acid causing gastric/duodenal ulcers

38
Q

What is the effect of an insulinoma?

A

Produces insulin causing body to store sugar rather than burn it
Hypoglycaemia

39
Q

What is the effect of glucagonoma?

A

Produces glucagon, increases blood sugar levels, hyperglycaemia

40
Q

Symptoms of pancreatic cancer

A 
Jaundice 
Back pain 
Abdo pain 
Weight loss 
Nausea 
Vomiting
41
Q

Risk factors for pancreatic cancer

A

Smoking
Charred meat
Obesity
Diabetes

42
Q

Investigations for pancreatic cancer

A

Ultrasound
CT scan
MRI/MRCP

43
Q

Treatment of inoperable pancreatic cancer

A

Stent or bypass (palliation)

44
Q

Treatment of operable pancreatic cancer

A

Whipple resection (tumour on head)
Total pancreatectomy
Distal pancreatectomy
Mid segment pancreatectomy

45
Q

What system is used to stage pancreatic cancer?

A

TNM classification

46
Q

What is the most common pathology of the biliary tract?

A

Gallstones

AY Gastrointestinal (21 decks)

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