Gallbladder and Pancreatic Disorders Flashcards

1
Q

Define cholelithiasis

A

Gallstones

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2
Q

Define choledocholithiasis

A

Bile duct stones

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3
Q

Populations affected by cholelithiasis

A
  • Native and Mexican Americans

- Fat Fertile Female Forties

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4
Q

Define biliary colic

A

Episodic pain attributed to gallstones WITHOUT evidence of cholecystitis

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5
Q

What confirms diagnosis of cholelithiasis?

A

RUQ ultrasound

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6
Q

Treatment of gallstones

A
  • Asymp = no treatment (dietary modifications, pain management for biliary colic episodes)
  • Elective surgery
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7
Q

Define cholecystitis

A

Acute or chronic inflammation of gallbladder

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8
Q

Causes of cholecystitis

A
  • 90% d/t gallstones

- 10% acalculous

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9
Q

What is best for diagnosing cystic duct obstruction?

A

HIDA scan

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10
Q

Treatment of cholecystitis

A
  • Analgesics/antiemetics
  • IV abx
  • Surgical resection or stent placement
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11
Q

Define porcelain gallbladder

A
  • Calcified, non-functional

- Caused by chronic cholecystitis (persistent inflammatory state)

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12
Q

Define emphysematous cholecystitis and treatment

A
  • Cholecystitits a/w gas-forming bacteria (clostridia, E. coli, Klebsiella)
  • Requires emergent resection
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13
Q

Define cholangitis

A

Common bile duct infection secondary to choledocholithiasis (bile duct stones)

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14
Q

Define primary sclerosing cholangitis

A

Common bile duct infection a/w IBD (NOT STONE)

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15
Q

Presentation of cholangitis

A
  • Charcot triad (RUQ pain, fever, jaundice)

- Reynolds pentad (Charcot + AMS and hypotension)

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16
Q

Describe MRCP vs. ERCP

A
  • Both used to diagnose cholangitis

- ONLY ERCP can be used as treatment too (sphincterotomy and stone retrieval)

17
Q

MC cause of acute pancreatitis

A

Stones

18
Q

Presentation of acute pancreatitis

A

Constant “boring” epigastric pain (gets better with leaning forward)

19
Q

How to assess severity of acute pancreatitis

A

Ranson criteria:

  • WBC 16+
  • Age 55+
  • Glucose 200+
  • AST 250+
  • LDH 350+
20
Q

What does x-ray show for acute pancreatitis?

A
  • Sentinel loop (LUQ air filled small bowel)

- Colon cutoff sign (gas filled transverse colon)

21
Q

Treatment of acute pancreatitis

A

Bowel rest!

22
Q

Define necrotizing pancreatitis

A
  • Complication of acute pancreatitis
  • Tissue destruction and hemorrhage resulting in Turner’s sign (hematoma in flanks) and Cullen’s sign (periumbilical discoloration)
23
Q

MC cause of chronic pancreatitis

A

Chronic ETOH

24
Q

How to diagnose chronic pancreatitis?

A
  • Secretin stimulation test (pancreatic secretions are diminished)
  • Fecal elastase test
  • Xray, US, CT
25
Q

Treatment of chronic pancreatitis

A
  • ETOH avoidance, low fat diet
  • Pain management with non opioids preffered
  • Pancreatic enzyme supplement
26
Q

Complication of chronic pancreatitis

A

Development of DM (80% within 25 yrs)

27
Q

Definition of pancreatic pseudocyst

A
  • Sterile, localized fluid collection in or on pancreas
  • Surrounded by fibrous or granulation tissue
  • Usually contains amylase or lipase
28
Q

Who gets pancreatic pseudocysts?

A
  • 20-40% chronic pancreatitis

- 10-25% acute pancreatitis

29
Q

Treatment of pancreatic pseudocysts

A
  • Supportive if asymptomatic

- Drainage if persistent symptoms, infection, hemorrhage, etc.