COW

Question 1

What are these symptoms of:
Vomiting. 
Postprandial Nausea.  
Epigastric fullness after eating just a few bites.
Abdominal bloating.
Heartburn.
Gastroesophageal reflux. 
Changes in blood sugar levels.
Lack of appetite.
Weight loss and malnutrition.
lack of electrolyte balance

Answer 1

gastroparesis

Question 2

What are these causes for:
Impaired glycemic control.

Extrinsic (e.g., vagal) and intrinsic neuropathies.

Abnormalities of Interstitial cells of Cajal.

Loss of nitric oxide synthase.

Myopathy.

Answer 2

gastroparesis

Question 3

What is inflammation of gallbladder?

Answer 3

cholecystitis

Question 4

What is choledocolethiasis?

Answer 4

When you have a gallstone in your common bile duct

Question 5

HOw do you diagnosis cholecystitis?

Answer 5

there is ongoing pain (constant)
Positive murphy’s sign
elevated Liver function test
thickened wall on Plain film

Question 6

What is pancreatitis?

What are the common causes of this?

Answer 6

Inflammation of the pancrease

biliary, alcholo, drugs, scorpion stings, hypercholesterolemia, ischemic/idiopathic, trauma or tumor

Question 7

What is chollithiasis?

Answer 7

the formation of gallstones

Question 8

What is cholangitis?

Answer 8

inflammation of bile ducts

Question 9

What are the typical demographics of cholelithiasis?

Answer 9

the four f’s

fat, fertile, female, forty

Question 10

What is cholecystitis?

Answer 10

inflammation of gall bladder

Question 11

WHat is biliary colic?

Answer 11

pain related to the gallbladder that occurs when a gallstone transiently obstructs the cystic duct and the gallbladder contracts

Question 12

What can cause a pancreatic obstruction?

Answer 12

tumor

Question 13

What is this:
Intermittent right upper quadrant pain
Lasts few minutes to hours
Occurs after eating fatty, greasy meal

Answer 13

biliary colic

Question 14

What is this:
Ongoing pain in RUQ
Elevated LFTs
Ultrasound findings

Answer 14

cholecystitis

Question 15

What is this:
Chronic autoimmune disease affecting the extra and intrahepatic bile ducts
Leads to cirrhosis
Only definitive treatment is liver transplant

Answer 15

cholangitis

Question 16

What is this:
Infection of the common bile duct from obstruction
Charcot’s triad – fever, RUQ abd pain, jaundice
Reynold’s pentad – plus confusion and hypotension
5-10% Mortality rate
Treatment is immediate ERCP and sphincterotomy after resuscitation and antibiotics

Answer 16

ascending cholangitis

Question 17

What is this:
Often constitutional symptoms
Weight loss, malaise, nausea, back pain
Jaundice is usual symptom that determines workup
Not usually evident until bilirubin level > 2
Itching may also be presenting factor
Evaluation 
CT scan

Answer 17

pancreatic mass

Question 18

What is this:

Stone in neck of gallbladder or cystic duct impinging on common bile duct

Answer 18

mirrizi’s syndrome

Question 19

What is this:
Less commonly seen now
Biliary fistula – cholecystoenteric fistula and stone causes obstruction at ileocecal valve

Answer 19

gallstone ileus

Question 20

Does choleithiasis require intervention?

Answer 20

no but once it becomes symptomatic yet

Question 21

What was the diagnosis of our patient for week 2?

Answer 21

ascending cholangitis