gallstones Flashcards

1
Q

what are gallstones

A

small stoned that form within gallbladder

most are made of cholsesterol

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2
Q

cholestasis

A

blockage to flow of bile

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3
Q

cholelithiasis

A

gallstones present

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4
Q

choledocholithiasis

A

gallstones in bile duct

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5
Q

biliary colic

A

intermittent RUQ pain

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6
Q

cholecystitis

A

inflammation of gallbladder

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7
Q

cholangitis

A

inflammation of bile ducts

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8
Q

cholecystectomy

A

removal of gallbladder

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9
Q

cholecystostomy

A

inserting drain into gallbladder

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10
Q

risk facors

A

fat
fair
female
forty

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11
Q

presentation

A
asymptomatic 
biliary colic 
severe, colicky RUQ pain
pain triggered by meals (esp high fat) 
N+V
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12
Q

how does fatty meals affect gallstones

A

fat entering GIT causes CCK secretion from duodenum
CCK triggers contraction of gallbladder which leads to biliary colic

pt w gallstones + biliary collic advised to avoid fatty meals

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13
Q

LFTs - bilirubin in obstructive picture

A

raised w dark urine and pale stools

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14
Q

LFTs; - alkaline phosphatase in obstructive picture

A

raised ALP in prescence of RUQ pain and/or jaundice is consistent w obstruction

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15
Q

LFTs - aminotransferase in obstructive picture

A

AST and ALT increase slightly, with higher rise in ALP

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16
Q

LFTs - aminotransferase in hepatic pictrue

A

ALT and AST high compared to ALP

17
Q

first line Ix

A

USS

18
Q

main indication for ERCR

A

clear stones in bile ducts

19
Q

complications of ERCP

A

excessive bleeding
cholangitis
pancreatitis

20
Q

management

A

cholecystectomy

21
Q

when is cholecystectomy indicated

A

symptoms of gallstones

gallstones leading to complications

22
Q

complications of cholecystectomy

A
bleeding, pain
infection, scars
bile duct damage 
stones left
damage to bowel
anaesthetic risks 
VTE 
post-cholecystectomy syndrome
23
Q

post-cholecystectomy syndrome

A
diarrhoea
indigestion 
epigastric/RUQ pain
nausea
intolerant fatty foods
flatulence
24
Q

gallstone complications

A

acute cholecystitis
acute cholangitis
pancreatitis