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GI II Final DF > Jandice and Biliary disorders CIS > Flashcards

Jandice and Biliary disorders CIS Flashcards

1
Q

unconjugated bilirubenemia disease that is usually greater than 20

A

Crigler-Najjar syndrome

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2
Q

reduced activity of uridine diphosphate glucournyl transferase is _____ and total bilirubin is usually around __

A

gilberts syndrome
3 when fasting
acutley ill

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3
Q

reduced excretory function of hepatocytes

A

dubin johnson

hyperpigmentation of the liver

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4
Q

reduced hepatic reuptake of bilirubin

A

rotor syndrome

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5
Q

stone in the common bile duct is ____ what would be seen on ultrasound

A

choledocholithiasis

would see common bile duct dilation

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6
Q

painless jaundice and mass

A

pancreatic cancer

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7
Q

rapid weight loss or weight gain is a risk factor for gallstones

A

weight loss

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8
Q

risk factor for emphysematious gallbladder

A

uncontrolled diabetic
bacterial infection with C perfringes

-findings–> positive murphys sign, rebound and guarding

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9
Q

most common location for cholycystitis

A

cystic duct

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10
Q

what is mareasy syndrome

A

stone in the cystic duct but it is pushing on the hepatic duct
would have increased liver enzymes

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11
Q

choledocholithiasis lab values

A

change in AST, ALT, alk phos, bilirubin

lipase could be elevated bc right by pancreatic duct opening

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12
Q

if you know that you have ascending cholangitis from choledocholithiasis then what is the treatment

A

emergent ERCP bc this is therapeutic and diagnostic

-would actually start antibiotics first

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13
Q

what is cholesterolosis

A

strawberry gallbladder

lipid laden macrophages, asymptomatic

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14
Q

what is hydrops of the gallbladder

A

chronic obstruction of the cystic duct that leads to resorption of normal GB contents that produces large amt of fluid

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15
Q

someone with UC and jaundice is at risk for getting

A

cholangiocarcinoma

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16
Q

when is clinical jaundice seen

A

bilirubin at or above 3

17
Q

what is normal bilirubin

A

0.2-1.2

18
Q

serum bilirbuin concentration in crigler naijar syndrome type 1, type 2, and gilbert’s syndrome

A

type 1: usually less that 20-50 mg.dL
type 2: usually less than 20
Gilbert: usually less than 3

19
Q

protective or risk factor for gallstone

-high intake of mg and polyunsaturead and monounsaturated fats in men

A

protective

20
Q

protective or risk factor for gallstone

-higher fiber diet and statins

A

protective

21
Q

protective or risk factor for gallstone

-ASA and NSAIDs

A

protective

22
Q

protective or risk factor for gallstone

-rapid weight loss

A

risk factor

23
Q

protective or risk factor for gallstone

-prolonged fasting

A

risk factor

24
Q

protective or risk factor for gallstone

-OCs and pregnancy

A

risk factor

25
Q

protective or risk factor for gallstone

-chrons disease

A

risk factor

26
Q

protective or risk factor for gallstone

-low carb diet

A

protective

27
Q

ultrasound finding of acute cholecystitis

A

GB wall thickening
pericholecystic fluid
sonographic murphy sign

28
Q

CT may show acute cholecysitis but has complications

A 
perforation
gangrene
abscess
peritonitis
emphysematious cholecystics
29
Q

choledocholithiasis and bile duct diameter

best seen on what

A

greater than 6mm on imaging

ERCP and EUS

30
Q

porcelain GB from

A

uncommon manifestation of chronic cholecystitis

  • incidental calcified lesion in region of GB
  • often asymptomatic
  • incresaed risk for development of GB cancer (poor prognosis)
31
Q

treatment for ascending cholangitiis

A

ampicillin-sulbactam
ticarcillin-CA
pipercilin-tazobactam

or ceftriaxone nad metronidazole

or fluoroquinoline plus metronizale

or monotherapy with carbapenem

32
Q

primary sclerosing cholangitis seen with what imaging and looks like what. what do you see on liver biopsy

A

ERCP/MRCP–> beads on a string

Liver biopsy: onion skinning

33
Q 
what is PSC associated with
what diseases
risk of what 
HLA types
other things
decrease risk with
age and sex
A 
UC
CVD and DM
risk of cholangiocarcinoma
HLA-B8 and DR3 or DR4
malabsorption of ADEK
esophageal varics
decrease risk with coffee consumption
males 20-50
34
Q

PBC associated conditions

A

sjogren syndrome
thyroid disease
scleroderma

35
Q

PBC antibodies

A

AMA positive

36
Q

PSC antibodies

A

ANCA positive 65% of time

GI II Final DF (9 decks)

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