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Progress > HPB > Flashcards

HPB Flashcards

1
Q

which scoring system is best for acute pancreatitis?

A

glasgow

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2
Q

what test is most sensitive for acute pancreatitis?

A 
serum lipase
(amylase can give false positive and negative results and doesn't correlate with disease severity)
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3
Q

management of acute pancreatitis due to gallstones

A

early cholecystectomy

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4
Q

management of obstructed biliary system due to stones

A

early ERCP

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5
Q

what is most suitable test for hep b screening?

A

HBsAg

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6
Q

positive anti-Hbs

A

immunity (immunisation/previous infection)

*s - successful

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7
Q

positive HBsAg

A

acute or chronic hep b

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8
Q

positive anti-HBc

A

previous/current infection

*c for caught it

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9
Q

positive HbeAg

A

marker of infectivity

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10
Q

what might you see on inspection in a case of pancreatitis?

A

cullen’s sign - periumbilical discolouration
grey turners sign - flank discolouration

CULlen - umbiliCAL

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11
Q

bilirubin, ALT/AST, ALP in prehepatic jaundice?

A

bilirubin - normal-high
ALT/AST - normal
ALP - normal

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12
Q

bilirubin, ALT/AST, ALP in hepatic jaundice?

A

bilirubin - high
ALT/AST - (v) high
ALP - moderately elevated

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13
Q

bilirubin, ALT/AST, ALP in post hepatic jaundice?

A

bilirubin - high-v high
ALT/AST - moderately raised
ALP - (v) high

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14
Q

what element in a history points to post hepatic jaundice?

A

pale stools

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15
Q

what can cause cholecystitis?

A

gallstones

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16
Q

what is charcots triad and when is it seen?

A

cholangitis (usually e coli)

fever, RUQ pain, jaundice

17
Q

how does pancreatic cancer present?

A

painless jaundice + palpable gallbladder

18
Q

what investigation is used for jaundice?

A

USS liver + biliary tree

19
Q

what investigation for pancreatic cancer?

A

CT

20
Q

what investigation for hepatic cancer or cholangiocarcinoma?

A

MRI/MRCP

21
Q

51y f. recurrent episodes epigastric pain radiating to back, brought on by heavy meals. drinks 20u/wk. current episode - yellow sclera. diagnosis?

A

common bile duct stones

pts often complain of epigastric pain rather than RUQ (so oft mistaken for dyspepsia).

22
Q

commonest cause of ascending cholangitis

A

gallstones

23
Q

ascending cholangitis - investigations + common results

A

inflammatory markers + bloods

USS abdo - dilatation of biliary duct

24
Q

ascending cholangitis - management

A

IV broad spec abx

ERCP after 24-48h to relieve obstruction

25
Q

what complication can result from chronic pancreatitis?

A

diabetes

26
Q

causes of chronic pancreatitis

A

80% alcohol

20% idiopathic

27
Q

features of chronic pancreatitis

A

pain 15-30min after meals

steatorrhoea (late stage)

28
Q

chronic pancreatitis - investigations + results

A

CT - pancreatic calcification

faecal elastase

29
Q

chronic pancreatitis - mgmt

A

pancreatic enzyme supplements

analgesia

30
Q

acute cholecystitis - presentation + examination finding?

A 
RUQ pain
vomiting
fever
local peritonitis
murphy's sign

jaundice is not common

31
Q

GETSMASHED

A 
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion
Hypertriglyceride, calcaemia, hypothermia
ERCP
Drugs
32
Q

which drugs can cause acute pancreatitis?

A

steroids
furosemide + bendroflumethiazide
azathioprine
sodium valproate

33
Q

acute alcoholic hepatitis - presentation

A

ill pt
fever
jaundice
leucocytosis

34
Q

primary biliary cholangitis - diagnosis

A

positive anti-mitochondrial antibodies

Progress (20 decks)

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