HPB

Question 1

Gallstone types

Answer 1

Chol
Pigment
Mixed

Question 2

colic defin

Answer 2

Pain due to contrac ag resis or obstruc in hollow viscus

Question 3

Biliary colic

Answer 3

Blocked cystic duct or stone in hartmans pouch
Small stone in CBD?
Pain only

Question 4

Cholecystitis

Answer 4

Inflamm of gb
Not necess infection but fever, WCC and inflamm markers pos
Mx- AB eg ceftriaxone plus metronidazole, tazobactam, ampicillin, meropenem.
Complics- mucocoele, empyema, sepsis, perf causing biliary chemical peritonitis (due to distension reducing BS to wall)

Question 5

Choledocolithiasis and cholangitis

Answer 5

Stone in CBD
Biliary colic plus jaundice
Stasis can cause infec which is cholangitis, severe sepstic resp.

Question 6

Ampulla stone

Answer 6

Risk pancreatitis

Question 7

gallstone ileus

Answer 7

Stone to duod via fistula
AXR findings- 10% gallst radio opaque, vs 90% renal stones. Gas in biliary tree.
Mirrizi synd- large stone impact hartmans pouch, pushes ag CBD or CHD causing obstruc. Can get fistula.

Question 8

Gallstone mx

Answer 8

AB if required
Lap chole
Duct clearance- ERCP, sphincterectomy

Question 9

Alfa feto protein

Answer 9

High in HCC

Spina bifida in utero