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RAD415 PT2 > HPB pathology > Flashcards

HPB pathology Flashcards

1
Q

what is billary colic

A
  • movement of gallstones through cystic duct causing colicky pain

(especially upon ingestion of fatty meal)

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2
Q

the duct that (typically) joins the gallbladder and the common hepatic duct; the union of the cystic duct and common hepatic duct forms the bile duct

A
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3
Q

where would you typically feel pain during billary colic

A

right upper quadrant of abdomen

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4
Q

how is billary colic commonly treated

A
  • analgesia (pain relief meds)
  • nil by mouth (you are not allowed to have any form of food, drink or medications by mouth)
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5
Q

if billary colic is reoccurent, what operation is done

A

cholecystectomy (removal of gall bladder)

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6
Q

what is cholecystitis

A

inflammation of gallbladder

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7
Q

where is cholecystitis pain usually felt

A

right upper quadrant pain with likely tenderness

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8
Q

what is the imaging choice for cholecystitis

A

gallbladder thickness on ultrasound

(generally no scan needed)

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9
Q

treatment for cholecystitis

A
  • cholecystectomy
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10
Q

how can common bile duct stones cause jaundice

A
  • stones prevent bile flow through common bile duct
  • bile is used to remove bilirubin from body
  • if this cannot be removed it causes jaundice
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11
Q

describe the stool produced by patients with bile duct stones

A

pale stools that float

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12
Q

what blood test is typically done to identify biliary obstruction

A

alkaline phosphatase (ALP) bloodiest

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13
Q

how/why does alkaline phosphatase test correlate to liver disease or relating

A

A high alk phos level occurs when there is a blockage of flow in the biliary tract or a buildup of pressure in the liver–often caused by a gallstone or scarring in the bile ducts.

  • its elevation in serum is correlated with the presence of bone, liver, and other diseases
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14
Q

what is cholangitis

A

inflammation of bile duct system

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15
Q

how can static bile cause cholangitis and potential sepsis

A
  • static bile is good culture medium for bacteria
  • if infected, billiary infections can make patients very sick and have full sepsis
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16
Q

charcot’s triad is often related to diagnosis of cholangitis, what are the 3 sypmtoms

A
  • fever
  • jaundice
  • right upper quadrant pain
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17
Q

what is the treatment for cholangitis

A
  • IV antibiotics
  • iv fluid
  • urgent removal of gall stone by ERCP (Endoscopic retrograde cholangiopancreatography)
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18
Q

what is pancreatitis

A

inflammation of pancreas

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19
Q

how can pancreatitis affect its enzyme activity

A
  • pancreatic enzymes are secreted in an inactive form, when they enter the gut they digest ur food
  • if pancreatic enzymes cant escape they may become prematurely activated and digest you
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20
Q

where is pain during pancreatitis felt

A

central abdominal pain that radiates to the back (midgut)

  • can also experience nausea and vomiting
21
Q

pain during pancreatitis is usually severe and needs IV morphine

A
22
Q

what are 3 indicators/diagnosis of pancreatitis

A
  • characteristic abdominal pain
  • serum amylase and/or lipase over 3x normal
  • characteristic signs on imagine
23
Q

what is the APACHE II scoring system on pancreatitis severity

A

acute physiology and chronic health evaluation II

24
Q

what are signs of pancreatitis on CT

A
  • inflamed tissue enlarged + increased contrast enhancement
  • necrotic tissue will not show enhancement
25
Q

what is a classic symptom of pancreatic cancer

A
  • painless jaundice
26
Q

main risk factors for pancreatic cancer

A
  • alcohol and smoking
  • family history
27
Q

what is the definition of acute liver failure

A
  • acute rise in liver enzymes accompanied by impaired synthetic function and encephalopathy (a disease in which the functioning of the brain is affected by some agent or condition (such as viral infection or toxins in the blood).)
  • loss of liver function that occurs quickly
28
Q

what is cirrhosis

A

scarring/fibrous tissue of liver due to long term liver failurre

29
Q

what virus could cause cirrhosis

A

hepatitis C

30
Q

What is the diagnosis done for cirrhosis

A
  • bloods and fibroscan test ( specialised ultrasound)
  • definitive diagnosis = biopsy
31
Q

what is treatment for cirrhosis

A
  • removing underlying cuase
  • liver transplant (when needed)
32
Q

what is the prognosis done / severity ranking for cirrhosis

A

Child–Pugh (score is used to assess the prognosis of chronic liver disease, mainly cirrhosis.)

UKMELD (United Kingdom Model for End-Stage Liver Disease)

33
Q

how can a cirrhotic liver cause gastroesophageal varicies

A
  • cirrhotic liver can prevent blood flow from GI tract passing through
  • hence, number of vessels draining the GI tract to the portal vein becomes enlarged
  • blood goes into veins lining oesophagus causing them to become enlarged)
34
Q

define varices

A

dilated veins

35
Q

what can be given to reduce portal blood flow during gastrooesophageal varices

A

terliprissin

36
Q

if there are severe bleeds due to gastroesophageal varices, what is used to manage this

A
  • sengstaken blakemore tubes ( tube inflated inside oesophagus to compress bleeding vessels)
37
Q

how do u prevent bleeding of gastroesophageal varices

A
  • ligation/banding and use of non-selective beta blockers (reduced portal blood flow)
38
Q

TIPS can also be used to prevent bleeding of gastroesophageal varices, what are these

A

transjugular intrahepatic protal shunts

39
Q

what is ascites

A
  • scarred liver impeding blood flow and increases portal vein pressure which
  • increases hydrostatic pressure in GI tissue leading to fluid accumulation in peritoneum
  • (fluid usually controlled by liver goes to neared place which is abdomen)
40
Q

how do you treat ascites

A
  • fluid drainage
  • sodium restriction
  • spironolactone (aldosterone receptor antagonist)
41
Q

why might you prescribe a patient who has ascites with prophylactic antibiotics

A
  • they are at risk of spontaneous bacterial peritonitis
42
Q

HPB pathology involved the liver, gallbladder and pancreas

A

c

43
Q

chole = relating to gallbladder

A
44
Q

where can gallstones be found

A

gallbladder, bile duct/biliary tract

45
Q

what are some risk factors for acute liver failure

A

You are at risk for acute liver failure if you:

Take too much acetaminophen.
Have certain diseases or infections, such as hepatitis, Wilson disease, and herpes simplex virus.
Drink a lot of alcohol.
Have poor blood flow to the liver.

46
Q

how can too much acetaminophen (paracetamol) cause liver damage

A

liver damage from acetaminophen occurs when the glutathione pathway is overwhelmed by too much acetaminophen’s metabolite, NAPQI

47
Q

liver does majority of digestion of drugs, alcohol etc

A
48
Q

what percentage of arteriole or venous blood goes to the liver

A

70% venous blood (deoxygenated blood with digested substances in it to be filtered)

30% arteriole blood

49
Q
A

RAD415 PT2 (14 decks)

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