Brainscape's Knowledge GenomeTM

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


See full index

MS3 - GI > Gallstone disease > Flashcards

Gallstone disease Flashcards

1
Q

Risk factors for Gallstones

A 
Female
Fair
Forty
Fertile (pregnant, COCP)
Fat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gallstone composition

A

Bile pigment stones 5%
Cholesterol stones 20%
Mixed stones 75%

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

Cholesterol gallstones

A

Large

Often solitary

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

Pigment gallstone

A

Small
Fragile
Calcium bilirubinate
Associated with haemolysis

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

Mixed gallstones

A

Often multiple

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

Complications of gallstones

A 
Biliary colic
Acute cholecystitis
Chronic cholecystitis
Mirizzi's syndrome
Obstructive jaundice
Pancreatitis
Cholangitis
Gallstone ileus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Biliary colic pathogenesis

A

Gallstone impacted in neck of gallbladder (Hartmann’s pouch)

Gallbladder spasm

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

Biliary colic presentation

A

RUQ pain - radiates to back / scapula
Attacks < 6 hrs
Worse with fatty food
Sweating

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

Investigations for biliary colic

A

Urine - bilirubin
Bloods
US - acoustic shadow

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

Management of biliary colic

A

Conservative:

  • Rehydrate
  • Nil by mouth
  • Analgesia

Surgical - laproscopic cholecystectomy

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

Acute cholecystitis pathogenesis

A

Gallstone impaction in Hartmann’s pouch
+ inflammation
+/- Empyema

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

Acute cholecystitis presentation

A

Contiuous RUQ pain
Radiates to right scapula + epigastrum
Fever
Vomiting

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

Acute cholecystitis examination findings

A

Local peritonsim RUQ
Tachycardia
Shallow breathing
Murphy’s sign

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

Acute cholecystitis investigations

A

Urine - bilirubin
↑WCC
US
MRCP (MRI cholangiopancreatography)

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

Conservative management of acute cholecystitis

A

Nil by mouth

Fluid resus

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

Medical management of acute cholecystitis

A

Analgesia

Abx: Cefuroxime + Metronidazole

17
Q

Surgical management of acute cholecystitis

A

Laproscopic cholecystectomy

18
Q

Acute cholecystitis empyema presentation and management

A

Fever
RUQ mass

Cholecystostomy - percutaneous drainage

19
Q

Chronic cholecystitis presentation

A 
Vague upper abdo discomfort
Distention
Nausea
Flatulence
Worse with fatty food
20
Q

Chronic cholecystitis investigations

A

AXR
US - gallstones, fibrotic, shrunken gallbladder
MRCP

21
Q

Management of chronic cholecystitis

A

Medical: bile salts
Surgical: cholecystectomy

22
Q

Rarer gallstone disease

A

Mirizzi’s syndrome

Gallstone ileus

23
Q

Mirizzi’s syndrome

A

Rare
Large stone in gallbladder compresses common hepatic duct
Leads to obstructive jaundice

24
Q

Gallstone ileus

A

Rare
Large stone errodes from gallbladder to duodenum
May impact in distal ileum and cause obstruction
Rigler’s triad

25
Q

Rigler’s triad

A

Associated with gallstone ileus

Pneumobillia
Small bowel obstruction
Gallstone in RLQ

26
Q

Management of gallstone ileus

A

Stone removal via enterotomy

27
Q

Bilirubin level where jaundice is noticable

A

50 - 75 mM

Seen at tongue frenulum first

28
Q

Causes of obstructive jaundice

A

Stones
Cancer of pancreas head
Mirizzi’s syndrome
Drugs - COCP, sulfonylureas

29
Q

Obstructive jaundice presentation

A

Jaundice
Dark urine
Pale stools (steatorrhoea)
Itch

30
Q

Obstructive jaundice investigations

A 
Urine - dark, bilirubin
↑WCC
Hepatorenal syndrome
↑conjugated bilirubin
↑ALP and ↑AST/ALT
↑INR (decreased vit K)
Immune: AMA, ANCA, ANA
AXR
US
MRCP
31
Q

Management of gallstone obstructive jaundice

A

Conservative:
- Monitor LFTs and wait for stone passage

Surgical:

  • ERCP with sphincterotomy and stone extraction
  • Cholecystectomy
32
Q

Ascending cholangitis gallstone location

A

Common bile duct

33
Q

Ascending cholangitis presentation

A

Charcot’s triad

Reynolds pentad

34
Q

Charcot’s triad

A

Fever
RUQ pain
Jaundice

35
Q

Reynolds pentad

A

Charcot’s triad + shock + confusion

Charcot’s triad = Fever, RUQ pain, Jaundice

36
Q

Management of ascending cholangitis

A

Cefuroxime + Metronidazole

ERCP with sphincterotomy and stone removal

MS3 - GI (16 decks)

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