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Gastro > Billiary tree > Flashcards

Billiary tree Flashcards

1
Q

What is Primary Billiary Cirrhosis

A

Progressive damage and eventual loss of the bile duct

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2
Q

What causes primary billiary cirrhosis

A

Fibrosis of the liver causes toxic bile acids to be retained in the liver causing damage to the bile duct

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3
Q

Risk factors of Billiary cirrhosis

A

Female
45-60
Hx/Fh of autoimmune disease

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4
Q

Signs & Symptoms of primary Billiary cirrhosis

A
  • Increased cholesterol
  • Itch
  • Dry eyes and mouth
  • fatigue
  • Postural dizziness
  • Jaundice
  • Hepatomegaly
  • Skin pigmentation
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5
Q

Mangement of primary billiary cirrhosis

A
  • bile acid analogue

- Liver transplant

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6
Q

What Antibodies do you investigate for in primary billiary cirrhosis

A
  • Anti-mitochondrial antibodies
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7
Q

What is cholecystitis

A

inflammation of the gallbladder

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8
Q

what are the symptoms of cholecystitis

A
  • RUQ
  • R shoulder pain
  • Murphys sign
  • (fever)
  • N&V
  • Anorexia
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9
Q

What are the risk factors of cholecystitis

A
  • Gallstones
  • DM
  • TPN
  • Severe illness
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10
Q

What is the management of cholecystitis

A
  • supportive
  • Oral/IV Abx
  • NSAIDs
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11
Q

What would you see on USS in cholecystitis

A
  • Distended GB
  • thickened GB wall
  • stones
  • Pericholecystic fluid
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12
Q

What is gallstone Ileus

A

when a gallstone moves out of the GB into the billiary tree and drops into the duodenum causing an obstruction of the bowl

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13
Q

What is Mirrizi’s Syndrome

A

Common hepatic duct obstruction due to extrinsic compression of a gallstone in the cystic duct

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14
Q

What is cholelithiasis

A

Gallstones: solid particles that form from bile cholesterol and bilirubin in the gallbladder

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15
Q

What are the risk factors for gallstones

A
  • Drugs
  • Pregnancy
  • FH
  • TPN
  • DM
  • Fat
  • AGe
  • NAFLD
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16
Q

What are the symptoms of gallstonse

A

Post prandial RUQ pain - cramping

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17
Q

what investigation should e done for suspected gallstones

A
  • USS
  • Bloods - normal
  • MRCP
  • Lipase/amylase
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18
Q

What are the differentials for gallstones

A
  • acute pancreatitis
  • hepatic abscess
  • peptic ulcer disease
  • Perforation
  • pyelonephritis
  • ## Lower lobe pneumonia
19
Q

What is ascending cholangitis

A

Inflammation of the bile duct, usually from bacteria ascending the biliary tree from the duodenum. Usuualy occurs when bile duct already compacted with gallstones

20
Q

What are the risk factors for ascending cholangitis

A
  • > 50
  • gallstones
  • Hx of sclerosing cholangitis
  • stricture: benign or malginant
21
Q

what are the symptoms of ascending cholangitis

A
  • Jaundice
  • fever
  • RUQ
  • hypotension
  • puritis
  • clay coloured stool
22
Q

What might you see in the bloods of someone with ascending cholangitis

A
  • raised WBC
  • raised CRP
  • Decreased platelet- raised urea and createnine
23
Q

What LFT and Coag results would you expect to see in someone with ascending cholangitis

A

ALP > ALT
raised billirubin
increased PTT

24
Q

What ABG result might you obtain in someone with ascending cholangitis

A
  • metabolic acidosos
  • low HCO3
  • raised lactate
25
Q

What might you see on the USS of someone with ascending cholangitis

A

dialted bile duct

gallstones

26
Q

What is the management of ascending cholangitis

A
  • IV ABx
  • ERCP - billiary decompression
  • Opiods
  • Lithotropy
  • Elective cholecystectomy
27
Q

What are the complications of ascending cholangitis

A
  • Perforation
  • Acute - hepatic abscess
  • bile duct injury during surgery
  • gangrenous cholecystitis
28
Q

What are the symptoms of acute pancreatitis

A
  • Epigastric pain radiating to back
  • anorexia
  • Hypovolaemia
  • Grey turners sign
  • Cullens sign
29
Q

What blood investigations should you complete for suspected acute pancreatitis

A
  • FBC, CRP, U&E, LFTs
  • Lipase/amylase
  • haematocrit if suspecting necrosis
  • ABG
30
Q

What imaging should you complete for suspected acute pancreatitis

A
  • MRCP
  • Abdo film
  • US
  • +/- CT
31
Q

What are the complications of acute pancreatitis

A
  • Sepsis
  • Necrosis
  • Acute lung injury
  • Acute renal failure
  • Pseudocyst - esp. if alcoholic
  • retroperitoneal bleeding
32
Q

What is the management fo acute pancreatitis

A
  • IV fluids
  • O2
  • Pain relief
  • anti-emetic
  • Ca/Mg replacement
  • May require insulin or Abx
  • nutrition support
33
Q

What are the risk factors for chronic pancreatitis

A
  • Alcohol
  • Smoking
  • FH
  • Coeliac
34
Q

What are the symptoms of chronic pancreatitis

A
  • Jaundice
  • N&V
  • Steatorrhoea
  • Malnutrition/weight loss
  • abdo pain
35
Q

What are the investigations for chronic pancreatitis

A
  • Blood glucose
  • Abdo Us
  • Abdo Xray
  • CT
36
Q

What is the management of chronic pancreatitis

A
  • stop smoking/drinking
  • pain relief
  • May require pancreatic enzymes
37
Q

What are the complications of chronic pancreatitis

A
  • DM
  • Duct obstruction
  • Opiod obstruction
  • low trauma #
  • pseudocyst
  • exocrine insufficienct
  • calcification
38
Q

What are the main causes of pancreatitis

A 
G: Gall stones
E: ethanol
T: Trauma
S: steroids
M: Mumps
A: Autoimmune
S: scorpion
H: hyper Ca/triglycerides
E: ERCP
D: Drugs
39
Q

What drugs are known to cause pancreatitis

A

azathioprine

diuretic - furesomide

40
Q

What are the RF of pancreatic cancer

A
  • FH

- SMoking

41
Q

What are the signs and symptoms of pancreatic cancer

A
  • Jaundice
  • Non-specific abdo pain
  • weight loss/anorexia
  • steatorrhoea
  • N&V
42
Q

What investigations should be carried out if suspecting pancreatic cancer

A
  • LFTs
  • CT
  • Abdo USS
43
Q

What is the management of pancreatic cancer

A
  • Surgery
  • Neoadjuvant radiotherapy
  • Enzyme replacement
  • Post op stenting

Gastro (9 decks)

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