Gallstones Flashcards

1
Q

What are gallstones commonly made up of?

A

Cholesterol

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2
Q

What are the risk factors for developing gallstones? (4)

A

F 4’s

  • Female
  • Fat (obese)
  • Forty
  • Fertile (pregnancy, OCP)
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3
Q

What are the clinical presentations of a pt w/ biliary colic?

A

RUQ pain after meals

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4
Q

How would you diagnose gallstones?

A

Ultrasound scan: gallstones

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5
Q

How would you treat asymptomatic gallstones?

A

No treatment!

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6
Q

What are the non-surgical treatments for biliary colic? (3)

A
  • Pain relief
  • Bile acid dissolution therapy
  • IV antibiotics if necessary
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7
Q

What are the surgical treatments for biliary colic?

A

Laparoscopic cholecystectomy

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8
Q

What is cholecystitis?

A

Inflammation of the gallbladder

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9
Q

What causes cholecystitis? (2)

A
  • Gallstones (common)

- Infections: E.coli

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10
Q

What are the clinical presentations of a pt w/ cholecystitis? (2)

A
  • Continuous RUQ pain

- Fever

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11
Q

What are the signs of cholecystitis? (2)

A
  • Boas sign: RUQ pain radiated to R shoulder

- Murphy’s sign: “catch” in breath when pressing on RUQ during deep breath

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12
Q

How would you investigate cholecystitis? (4)

A
  • FBC: raised CRP, WCC
  • LFT: raised ALT (alkaline phosphatase)
  • Ultrasound: stones, wall thickening, pericholecystic fluid
  • ERCP
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13
Q

How would you treat cholecystitis? (4)

A
  • Fluid resuscitation
  • Antibiotic therapy
  • ERCP: clear obstruction
  • Cholecystectomy
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14
Q

What is cholangitis?

A

Infection of the bile duct

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15
Q

What are the clinical presentations of cholangitis? (3)

A
  • RUQ pain
  • Jaundice
  • Fever
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16
Q

What are the common signs of cholangitis? (2)

A
  • Charcot’s triad

- Reynold’s pentad

17
Q

What is Charcot’s triad?

A
  • RUQ pain
  • Fever (+ rigors)
  • Jaundice
18
Q

What is Reynold’s pentad?

A
  • RUQ pain
  • Fever
  • Jaundice
  • Hypotension
  • Confusion
19
Q

How would you treat cholangitis? (2)

A
  • ERCP -(suction gallstone out)

- Antibiotics: piperacillin, tazobactam