Hepatobiliary Diseases Flashcards

1
Q

what is contained in bile

A

water, bile salts, cholesterol and bilirubin

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2
Q

what is bilirubin made from

A

from the breakdown of haem

70-905 from RBCs
10-30% from myoglobin

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3
Q

what is bile green

A

because of bilirubin pigment

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4
Q

what makes poo brown

A

stercobilin

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5
Q

how does unconjugated bilirubin travel to the liver

A

bound to albumin

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6
Q

what are the types of jaundice

A

pre-hepatic
hepatic
post-hepatic

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7
Q

prehepatic cause of jaundice

A

too much unconjugated bilirubin arriving at liver and can’t all be conjugated
due to haemolysis or Gilbert’s

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8
Q

cause of hepatic jaundice

A

cirrhosis
sepsis
right heart failure

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9
Q

post hepatic jaundice cause

A

blockage

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10
Q

which is soluble conjugated or unconjugated jaundice

A

conjugated

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11
Q

dark urine and pale stool is due to

A

post-hepatic jaundice/blockage

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12
Q

itch is associated with what type of jaundice

A

post-hepatic

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13
Q

post hepatic jaundice aka

A

obstructive jaundice

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14
Q

what is whipple’s procedure

A

surgery to remove head of pancreas, gallbladder and connect the stomach to the jejenum bypassing the duodenum

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15
Q

when is Whipple’s procedure used

A

pancreatic and distal bile duct cancers
not when there is metastasis

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16
Q

what investigation can be done for obstructive jaundice

A

ERCP
endoscopic retrograde cholangiopancreatography

17
Q

peripheral stigmata of liver disease

A

clubbing
palmar erythema
dupuytren’s
jaundice
vrichow’s nodes
spider naevi
gynaecomastia

18
Q

what is virchow’s nodes and what is it a sign of

A

lump in neck
cancer

19
Q

what does ALP>ALT/AST suggest

A

obstructive picture

20
Q

what does ALP<ALT/AST suggest

A

liver disease

21
Q

gallstones more common in male or female

A

female

22
Q

presentation of gallstones

A

RUQ or epigastric pain
colicky or constant
dyspepsia
nausea
vomiting

23
Q

management of gallstones

A

analgesia
antibiotics
percutaneous drainage
ERCP
surgery to remove gallbladder

24
Q

what is the surgery called to remove gallbladder

A

laparoscopic cholecystectomy