Gastroenterology Flashcards
What are signs/symptoms of biliary colic?
- episodic cramps pain in RUQ exacerbated after a fatty meal
- nausea and vomiting
What is the pathophysiology of biliary colic?
Gallstone in the gallbladder. Transient obstruction but no inflammation
What is the pathophysiology of acute cholecystitis?
Inflammation of the gallbladder which is precipitated by obstruction of cystic duct (cholelithiasis)
What are the symptoms/signs of acute cholecystitis?
- RUQ pain, fever, n+v (+ Murphy’s sign)
- tachycardia
- gall bladder wall thickening > 4 mm
- obese
- triggered by fatty meal
- slightly deranged LFTs. High WBC + CRP
- No jaundice
What are complications of acute cholecystitis?
- gangrenous cholecystitis
- perforation
- abscess formation
- cholecystoenteric fistula
What is the pathophysiology of ascending cholangitis?
Bacterial infection if the biliary tree (e. Coli)
Caused by gallstones or gallstones
What are signs/ symptoms of ascending cholangitis?
- charcot’s traid/ Reynold’s Pentad : RUQ pain, fever, jaundice
What is treatment of biliary colic?
Analgesia, hydration, elective lap cholecystectomy
What is management of acute cholecystitis?
Fluid resuscitation analgesia, IV antibiotics, lap cholecystectomy within 1 week
What is management of ascending cholangitis?
Admit, fluid resus, IV antibiotics, urgent ERCP
What is treatment of autoimmune hepatitis?
Prednisolone 30 mg and azathioprine 50 mg. For at least e more years before considering stopping meds. Safe to use during pregnancy / benefits outweigh the risks
