Cholecystitis, PBC, PSC, Jaundice

Question 1

Chronic cholecystitis is defined by repetitive episodes of __ __ in the presence of partial blockage of the __ __

Answer 1

biliary colic

cystic duct

Question 2

The difference between chronic cholecystitis and biliary colic is that in the former the episodes are not associated with consuming ____

Answer 2

fatty food

Question 3

Diagnosis of chronic cholecystitis is made with ___ or ___

Answer 3

US

HIDA

Question 4

Treating chronic cholecystitis is made with elective ___

Answer 4

cholecystectomy

Question 5

Primary biliary cirrhosis is characterized by high ___ and positive ___

Answer 5

globulin

AMA (Anti-mitochondrial antibody)

Question 6

PBC is a chronic ___ disease of the ___ hepatic bile ducts, mediated by __ cells

Answer 6

progressive
intra
T

Question 7

Most PBC patients are ___ between the ages of -

Answer 7

women

35-60

Question 8

PBC common symptoms include ___ and ___. Other less common symptoms are: (3)

Answer 8

pruritus 
weakness
hyperpigmentation
xanthomata
bone pain

Question 9

PBC leads to liver ___, therefore we will see characteristics symptoms such as ___

Answer 9

cirrhosis

clubbing

Question 10

The typical lab of PBC will include: (4)

Answer 10

elevated ALK-P
elevated GGT
elevated globulin (IgM)
positive AMA

Question 11

In 10% of cases of PBC there is an overlap with ___

Answer 11

AIH

Question 12

The only effective treatment for PBC is ___, but the definitive treatment is liver ___

Answer 12

UDCA

transplantation

Question 13

PSC is a ___ progressive disease of the ___and ___ hepatic bile ducts

Answer 13

chronic
intra
extra

Question 14

The fibrosis (or ___) of the involved bile ducts in PSC will eventually lead to biliary ___, portal ___, and liver ___.

Answer 14

sclerosis
cirrhosis
HTN
failure

Question 15

The typical imaging picture of PSC is of __ __.

Answer 15

pearl neckless

Question 16

PSC is more common in ___ between the ages of -

Answer 16

men

25-45

Question 17

70% of PSC patients also suffer from ___

Answer 17

UC

Question 18

Diagnosis of PSC is made with ___, showing peal neckless without the presences of ___

Answer 18

MRCP

stones

Question 19

We should suspect PSC when the lab results show ___ picture + negative ___. In 65% of cases we will also see positive __

Answer 19

cholestatic
AMA
P-ANCA

Question 20

PSC patients are in an increased risk for ___ and ___

Answer 20

cholangiocarcinoma

gallbladder cancer

Question 21

The only definitive treatment for PSC is ___ transplantation

Answer 21

liver

Question 22

Direct hyperbilirubinemia is when D/T > ___%

Answer 22

40

Question 23

Indirect hyperbilirubinemia is when D/T< ___%

Answer 23

20

Question 24

Indirect hyperbilirubinemia suggest ___ jaundice

Answer 24

hemolytic

Question 25

Direct hyperbilirubinemia + elevated transaminase + normal ALK-P = ____ jaundice

Answer 25

hepatocellular

Question 26

Direct hyperbilirubinemia + normal transaminase + high ALK-P = ____ jaundice

Answer 26

obstructive

Question 27

Obstructive jaundice is characterized by: (5)

Answer 27

jaundice
dark urine
light feces (acholia)
pruritus
anorexia/nausea

Question 28

The most common cause for obstructive jaundice is ___, followed by: (3)

Answer 28

choledocholithiasis
pancreatitis
periampullary disease (pancreas head carcinoma…)
Mirizzi’s syndrome