Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 Surgery > HPB > Flashcards

HPB Flashcards

1
Q

What is Bile formed from?

A

Cholesterol, Phospholipids and Bile pigments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is bile stored?

A

Gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why do Gallstones form?

A

Due to a supersaturation of bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the different types of gallstone?

A

Cholesterol Stones
Pigment Stones
Mixed Stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are Cholesterol stones formed?

A

Formed from excess cholesterol, linked to poor diet and obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are Pigment stones formed?

A

Formed from bile pigments due to an excess pigment production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are Mixed gallstones formed of?

A

A mixture of Cholesterol and Bile pigments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some risk factors for Gallstone disease?

A 
The 5 Fs
Pregnancy
Oral contraceptives
Haemolytic anaemia
Malabsorption conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 5 Fs in relation to gallstones?

A 
Fat
Female
Fertile
Fourty
Family Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Biliary colic?

A

Condition when the gallbladder neck becomes impacted with a gallstone. There are no features of inflammation, however can have pain due to contraction of the neck against the stone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is the pain often described in biliary colic?

A

Sudden
Dull
Colicky

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is the pain felt in biliary colic?

A

RUQ

Can radiate to Epigastrium +/- Back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can often trigger biliary colic?

A

Consumption of fatty foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the management options for biliary colic?

A

Analgesia - Paracetamol +/- NSAIDs. Opioids if needed
Lifestyle modifications
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should a Laparoscopic Cholecystectomy be offered with biliary colic?

A

Within 6/52 of initial presentation, due to risk of recurrence/complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Acute Cholecystitis?

A

Inflammation of the gallbladder due to stone impaction

17
Q

How does Acute Cholecystitis present?

A

Constant RUQ pain
Signs of inflammation - Lethargy, fever
Murphy’s +ve

18
Q

What are some other possible differentials with Acute Cholecystitis?

A

GORD
Peptic Ulcer disease
Acute pancreatitis
IBD

19
Q

What abnormalities may be present in bloods with Acute Cholecystitis?

A

Raised CRP

Raised ALP

20
Q

Which imaging is first-line with suspected Acute Cholecystitis?

A

USS

21
Q

What does USS demonstrate in acute cholecystitis?

A

Presence of gallstones/sludge
Increased gallbladder wall thickness
Bile duct dilatation

22
Q

When should an MRCP be performed with suspected Acute Cholecystitis?

A

If USS is inconclusive

23
Q

What are the management steps for acute cholecystitis?

A

IV Abx - Co-Amoxiclav +/- Metronidazole
Analgesia and Antiemetics
Laparoscopic Cholecystectomy within 1 week
Percutaneous drainage if unsuitable for Lap Chole

24
Q

What is Mirizzi Syndrome?

A

A stone in the cystic duct compresses the common hepatic duct giving obstructive jaundice

25
Q

What can gallbladder inflammation lead to?

A

Formation of a cholecystoduodenal fistula allowing gallstones to pass directly to small bowel

26
Q

What is Bouveret’s Syndrome?

A

Stone impaction in proximal duodenum causing a gastric outlet obstruction

27
Q

What is Gallstone ileus?

A

Stone impaction at the terminal ileus giving small bowel obstruction

28
Q

What is Cholangitis?

A

Infection of the biliary tree due to a combination of biliary outflow obstruction and biliary infection

29
Q

Why does biliary obstruction lead to Cholangitis?

A

Stasis of fluid combined with elevated intraluminal pressure allows for bacterial colonisation of the biliary tree to become pathological

30
Q

What are some common causes of cholangitis?

A 
Gallstones
ERCP
Cholangiocarcinoma
Pancreatitis
Primary Sclerosing Cholangitis
31
Q

What are the common causative organisms of Cholangitis?

A

E. Coli
Klebsiella
Enterococcus

32
Q

What are some clinical features of Cholangitis?

A 
RUQ Pain
Fever
Jaundice
Pyrexia
Rigors
Hypotension
33
Q

What is Charcots Triad in relation to Cholangitis?

A

Pain
Fever
Jaundice

34
Q

What is Reynolds Pentad in relation to Cholangitis?

A 
Jaundice
Fever
RUQ Pain
Hypotension
Confusion
35
Q

What may bloods demonstrate in Cholangitis?

A

Raised ALP, Gamma GT and Bilirubin

36
Q

What is the gold-standard imaging for suspected Cholangitis?

A

ERCP

37
Q

What is the appropriate management of Cholangitis?

A

IV Abx

Systemic Support/Sepsis management

38
Q

How can Cholangitis be treated?

A

ERCP +/- Sphincterotomy/Stenting

Year 3 Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions