Hepatobiliary Diseases Flashcards
what is contained in bile
water, bile salts, cholesterol and bilirubin
what is bilirubin made from
from the breakdown of haem
70-905 from RBCs
10-30% from myoglobin
what is bile green
because of bilirubin pigment
what makes poo brown
stercobilin
how does unconjugated bilirubin travel to the liver
bound to albumin
what are the types of jaundice
pre-hepatic
hepatic
post-hepatic
prehepatic cause of jaundice
too much unconjugated bilirubin arriving at liver and can’t all be conjugated
due to haemolysis or Gilbert’s
cause of hepatic jaundice
cirrhosis
sepsis
right heart failure
post hepatic jaundice cause
blockage
which is soluble conjugated or unconjugated jaundice
conjugated
dark urine and pale stool is due to
post-hepatic jaundice/blockage
itch is associated with what type of jaundice
post-hepatic
post hepatic jaundice aka
obstructive jaundice
what is whipple’s procedure
surgery to remove head of pancreas, gallbladder and connect the stomach to the jejenum bypassing the duodenum
when is Whipple’s procedure used
pancreatic and distal bile duct cancers
not when there is metastasis
what investigation can be done for obstructive jaundice
ERCP
endoscopic retrograde cholangiopancreatography
peripheral stigmata of liver disease
clubbing
palmar erythema
dupuytren’s
jaundice
vrichow’s nodes
spider naevi
gynaecomastia
what is virchow’s nodes and what is it a sign of
lump in neck
cancer
what does ALP>ALT/AST suggest
obstructive picture
what does ALP<ALT/AST suggest
liver disease
gallstones more common in male or female
female
presentation of gallstones
RUQ or epigastric pain
colicky or constant
dyspepsia
nausea
vomiting
management of gallstones
analgesia
antibiotics
percutaneous drainage
ERCP
surgery to remove gallbladder
what is the surgery called to remove gallbladder
laparoscopic cholecystectomy
