Brainscape's Knowledge GenomeTM

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


See full index

Gastroenterology > Cholangitis > Flashcards

Cholangitis Flashcards

1
Q

What is acute cholangitis?

A

Infection and inflammation of the biliary tree

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

What are the causes of cholangitis?

A

Gallstones in the CBD
Infection introduced during ERCP
Cholangiocarcinoma
Biliary strictures

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

What organisms most commonly cause acute cholangitis?

A

E. coli
Klebsiella
Enterococcus

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

What is charcot’s triad?

A

RUQ pain
Fever
Jaundice

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

What are the clinical signs and symptoms of acute cholangitis?

A

RUQ abdominal pain
Jaundice
Fever
Pruritis
Dark urine and pale stool
Confusion
Hypotension

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

What is Reynold’s pentad?

A

Charcot’s triad
+ Confusion and hypotension

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

What imaging is used in the diagnosis of acute cholangitis?

A

Abdominal ultrasound scan - first line
CT scan
MRCP - gold standard
Endoscopic ultrasound

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

What other investigations are useful in the diagnosis of acute cholangitis?

A

FBC
LFTs - obstructive jaundice
- ALP > ALT
U&Es
CRP
VBG
Blood cultures - before commencing antibiotics

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

What is the initial management of acute cholangitis?

A

IV antibiotics - broad spectrum with gram-negative and anaerobic cover
IV fluids

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

What is the definitive management of acute cholangitis?

A

ERCP - first line
PTC (percutaneous transhepatic cholangiogram)

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

What is PTC?

A

A drain is inserted radiologically through the skin and liver, into the bile ducts - this drain relieves the immediate obstruction

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

What procedures can be performed during ERCP?

A

Cholangio-pancreatography - visualising biliary system
Sphincterotomy - makes a cut in the sphincter to dilate it and allow stone removal
Stone removal
Balloon dilatation
Biliary stenting
Biopsy

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

What is primary sclerosing cholangitis?

A

An immune mediated chronic liver disease, where the intrahepatic and extrahepatic bile ducts become inflamed, fibrosed and destroyed

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

What condition is primary sclerosing cholangitis associated with?

A

Ulcerative colitis

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

What are the risk factors for primary sclerosing cholangitis?

A

Male
Aged 30-40
Ulcerative colitis
Family history

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

What is the presentation of primary sclerosing cholangitis?

A

RUQ pain
Pruritis
Fatigue
Jaundice
Hepatomegaly
Splenomegaly

17
Q

What blood tests are used in the diagnosis of primary sclerosing cholangitis?

A

ALP
Gamma-GT
Bilirubin
ALT/AST
pANCA
ANA

18
Q

What is the diagnostic investigation of choice for primary sclerosing cholangitis?

A

MRCP

19
Q

What is the management of primary sclerosing cholangitis?

A

Observation and lifestyle optimisation
Cholestyramine - relieves pruritis
Fat soluble vitamin supplementation
Liver transplantation - advanced disease

20
Q

What are the complications of primary sclerosing cholangitis?

A

Biliary strictures
Acute bacterial cholangitis
Cholangiocarcinoma
Cirrhosis
Fat soluble vitamin deficiency
Osteoporosis

21
Q

What is primary biliary cholangitis?

A

An autoimmune condition characterised by granulomatous destruction of the intrahepatic bile ducts
- This leads to cholestasis and subsequent leakage of bile into the circulation
- The back pressure of bile can lead to liver fibrosis and cirrhosis

22
Q

What conditions are associated with primary biliary cholangitis?

A

Sjogren’s syndrome
Raynaud’s syndrome
Autoimmune thyroid disease
Rheumatoid arthritis
Systemic sclerosis

23
Q

What is the presentation of primary biliary cholangitis?

A

Fatigue
Pruritis
Abdominal pain
Jaundice
Pale, greasy stools
Dark urine
Xanthoma and xanthelasma
Hepatomegaly

24
Q

What investigations are used in the diagnosis of primary biliary cholangitis?

A

ALP, GGT, bilirubin - raised
Coagulation profile
Raised IgM
Antibodies:
- AMA
- ANA
- Smooth muscle antibodies

25
Q

What is the first line treatment of primary biliary cholangitis?

A

Ursodeoxycholic acid
Fat soluble vitamin supplementation
Cholestyramine

26
Q

What is ursodeoxycholic acid?

A

A bile acid analogue
- Dampens the inflammatory response and improves cholestasis

27
Q

What are the complications of primary biliary cholangitis?

A

Malabsorption of fat-soluble vitamins
Hypercholesterolaemia
Liver cirrhosis
Hepatocellular carcinoma

Gastroenterology (23 decks)

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