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GI Final > Jaundic And Biliary Disorders CIS > Flashcards

Jaundic And Biliary Disorders CIS Flashcards

1
Q

Dublin Johnson syndrome

A

You get the really black liver

  • normal AST/ALT and CBC
  • galbladder wall thickening
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2
Q

What will predispose a pregnant lady who is having cholecystitis to recurrence of symptoms?

A

Taking oral contraceptives

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3
Q

Which blood will give you hyperbilirubinemia?

A

Sickle cell anemia

-more destruction of RBC’s

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4
Q

Faulty excretion of bilirubin

A

Dublin Johnson

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5
Q

Impaired bilirubin storage

A

Gilbert’s

-the intense one is criggler Najjar

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6
Q

Charcot’s triad

A

For ascending cholangitis

  • jaundice
  • fever
  • RUQ pain
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7
Q

Which one is a painless jaundice… They show up and they’re yellow and they don’t know why?

A

Pancreatic cancer!

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8
Q

“Shock liver”

A

Ischemic hepatitis

-they will be REALLY sick

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9
Q

Episodic RUQ pain

A

Think choledocalithiasis

-diabetes is a risk factor for gallstone production

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10
Q

If you see a porcelain gallbladder, what should we worry about

A

Fucking cancer!

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11
Q

What is emphysematous gallbladder

A

Air around the gallbladder

  • in uncontrolled diabetics
  • bacterial infection with Th gas-forming organism: C. Perfringes
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12
Q

Where do stones get lodged when it hurts like hell in the gallbladder?

A

The cystic duct!

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13
Q

In alcoholic pancreatitis, which is higher, AST or ALT?

A

AST

-that’s why it’s the weird one

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14
Q

What is primary sclerosing cholangitis associated with?

A

Ulcerative colitis

-remember the pANCA

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15
Q

In choledocalithiasis, what pancreatic enzyme is elevated?

A

Lipase

-stone in the common bile duct…. Backs EVERYTHING up

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16
Q

What is ERCP

A

Endoscopic retrograde cholangiopancreatograhy

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17
Q

What is MRCP

A

Magnetic retrograde cholangiopancreatograhy

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18
Q

Where will we have a somatic dyfunction in gallbladder disease

A

T5-7

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19
Q

What gives you a strawberry gallbladder?

A

Cholesterolosis

20
Q

What is porcelain gallbladder

A

From chronic cholecystitis

-increased risk of gallbladder cancer

21
Q

What are the 2 kinds of jaundice you can have?

A

Unconjugated or conjugated

22
Q

Indirect vs. direct bilirubin

A

indirect is unconjungated

direct is conjugated

23
Q

What are the 2 caused of unconjugated jaundice?

A
  • increase bilirubin production

- impaired bilirubin uptake and storage

24
Q

what can result from increased bilirubin production?

A

hemolysis

hematoma

25
Q

What can result from impaired bilirubin uptake and storage?

A
  • posthepatitis
  • Gilbert syndrome
  • Crigler-Najjar syndrome
  • drug reaction
26
Q

What are the 3 causes of conjugated jaundice?

A
  • impaired excretion
  • hepatocellular dysfunction
  • biliary obstruction
27
Q

What can happen with impaired excretion?

A

Dubin johnson
rotor syndrome
choestasis

28
Q

what can happen with hepatocellular dysfunction?

A

hepatitis/cirrhosis

-infection

29
Q

What can happen with biliary obstruction?

A
  • choledocholithiasis
  • biliary atresia
  • pancreatitis
  • carcinoma of bile duct or pancreas
30
Q

At what level of bilirubin is clinical jaundice seen?

A

> or = 3

  • hemolysis alone rarely elevates bilirubin
  • white people and mexicans
31
Q

What is ERCP and where does it go?

A

Endoscopic Retrograde Cholangiopancreatography

  • down through the stomach into the proximal duodenum
  • then, a thing comes out that goes into the sphincter of oddi the other way and up the common bile duct
32
Q

What is MRCP?

A

Magnetic resonance cholangiopancreatography

-it looks like an xray with contrast…

33
Q

What is EUS?

A

endoscopic ultrasound

34
Q

What will galltones show on Ultrasound?

A

and ACOUSTIC SHADOW

35
Q

What are some risk factors for gallstones?

A

female

  • old
  • fat
  • DM
  • crohn disease… pigment stones
  • oral contraceptives
  • Fair, Fat, female, fertile, forty?, family hx
36
Q

What are some protective factors for gallstones?

A
  • low carb
  • active
  • COFFEE!
  • ASA and NSAIDs
37
Q

Acute Cholecystitis

A

GB wall thickening, pericholecystic fluid, and a sonographic murphy sign

38
Q

complicates of cholecystitis

A

Perforation, gangrene, abscess, peritonitis, emphysematous choecystitis

39
Q

Choledocholithiasis

A

common bile duct stone

  • best seen on ERCP or EUS
  • can possibly see on US, CT
  • Can see on MRCP, but usually go on to ERCP since diagnostic and therapeutic
40
Q

What is a potential complication of ERCP?

A

iatrogenic pancreatitis

41
Q

What was that thing she had in bold on the choledocholithiasis slide?

A

Bile duct diameter greater than 6mm imaging

42
Q

What does a Porcelain Gallbladder mean?

A

increased risk for development of gallbladder carcinoma, which has a poor prognosis
-incidental calcified lesion… usually asymptomatic

43
Q

What is Charcot’s triad

A

it means ascending cholangitis

  • Jaundice
  • Fever
  • RUQ pain
44
Q

What can cause/ what is reynold’s pentad?

A

the presence of pus in the biliary ducts

-Charcot’s triad plus hypotension and confusion

45
Q

What does primary sclerosing cholangitis show on ERCP and MRCP and what does the liver biopsy look like?

A
  • beads on a string

- onion skinning

46
Q

What is PSC associated with?

A

men

  • UC!!!!
  • increased risk of cholangiocarcinoma
  • same for colon cancer (from UC)
  • malabsorption of ADEK, esophageal varices, osteoporosis
47
Q

dx PSC

A

MRCP or ERCP

GI Final (13 decks)

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