Brainscape's Knowledge GenomeTM

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


See full index

Surgery > Jaundice > Flashcards

Jaundice Flashcards

1
Q

Which structure divides the liver into right and left lobes?

A

The falciform ligament

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

Blood supply and drainage of the liver?

A

Supply- the hepatic artery and portal vein

Drainage- right, middle and left hepatic veins, draining into inferior vena cava

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

What is the functional unit of the liver?

A

The hepatic acinus

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

Describe the structure of the acinus with respect to blood flow from the portal system?

A

Sheets of hepatocytes, separated by interlacing venous sinusoids draining to a branch of the hepatic vein in the centre

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

Functions of the liver?

A 
Storage of glucose as glycogen
Lipid metabolism
Metabolism of drugs
Storage of vitamins and minerals
Synthesis of coagulation factors
Synthesis of albumin
Removal of damaged blood cells/viruses/toxins/bacteria from circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Jaundice is caused by…?

A

Increase in circulating bilirubin

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

Classification of jaundice?

A

Haemolytic
Hepatocellular (unconjugated)
Cholestatic (conjugated)

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

Why does cholestatic jaundice cause pale stools and dark urine?

A

Blocked biliary tree means bile cannot pass into digestive system; the bilirubin is conjugated meaning it is water soluble, and stains the urine dark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

High levels of unconjugated bilirubin in the serum, but no bilirubin in the urine suggests what type of jaundice?

A

Haemolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Obstruction causes what pattern of LFT derangement?

A

Elevated alkaline phosphatase and bilirubin with moderately increased ALT/AST

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

Why does biliary obstruction cause pruritus?

A

Inability to secrete bile salts into the obstructed biliary system

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

Stigmata of chronic liver disease? (6)

A 
Spider naevi
Gynaecomastia
Testicular atrophy
Palmar erythema
Ascites
Caput medusae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are caput medusae?

A

Large collateral veins in the peri-umbilical region

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

Radiological techniques to investigate obstructive symptoms/LFTs?

A

Ultrasound
MRCP
ERCP
CT

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

Drawback and advantage of ERCP?

A

Drawback- can cause cholangitis, pancreatitis

Advantage- can be used to endoscopically treat stones, tumours, insert stents

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

Symptoms of pyogenic liver abscess?

A

Pyrexia, rigors, jaundice, tender liver

17
Q

Management of pyogenic abscess?

A

Percutaneous drainage of accessible abscesses, leaving a drainage tube in place
Antibiotic therapy based on C+S

18
Q

What is the commonest aetiological factor in portal hypertension in a) developed countries b) North Africa, China, MIddle east?

A

a) alcohol/cirrhosis

b) schistosomiasis

19
Q

At what three sites does portosystemic shunting occur in portal hypertension? (3)

A

Oesophageal/gastric fundus venous plexus

Veins of anterior abdominal wall

Rectal plexus

20
Q

Haematological consequences of portal hypertension?

A

Enlargement of the spleen, causing anaemia thrombocytopenia and leucopenia

21
Q

Aetiology of ascites?

A

Increased lymph formation; hypoalbuminaemia; salt and water retention

22
Q

Symptoms of cirrhosis?

A

Anorexia, malaise, weight loss

Stigmata of chronic liver disease

23
Q

What do slurring of speech, flapping tremor and dysarthria indicate in the cirrhotic patient?

A

Hepatic encephalopathy

24
Q

What is the main differential diagnosis which should be considered in a patient presenting with presumed variceal bleeding?

A

Bleeding from peptic ulcer

25
Q

Why are patients with portal hypertension more likely to bleed profusely?

A

Hypersplenism causing thrombocytopenia; decreased synthetic capacity of the liver causing prolonged prothrombin time

26
Q

What is the preferred method of treatment of oesophageal varices?

A

Active resuscitation (blood, FFP/platelets according to haematology advice)

Endoscopic variceal band ligation

27
Q

What procedure can be used as a temporary holding measure in acute variceal bleeding?

A

Oesophageal tamponade with a Sengstaken-Blakemore tube

28
Q

Primary prevention of variceal bleeding in patients with cirrhosis?

A

Endoscopic surveillance; beta blockers/sclerotherapy/ligation

29
Q

What is the vasoactive drug of choice in suspected acute variceal bleeding?

A

Terlipressin

30
Q

What procedure can be used to decompress the portal system?

A

Transjugular intrahepatic portosystemic shunt (TIPSS)

31
Q

Control of ascites?

A

Salt and water restriction

Spironolactone (alsoterone inhibitor)

32
Q

Disease characterised by inflammation and fibrosis of intra- and extra-hepatic bile ducts?

A

Primary sclerosing cholangitis

33
Q

PSC is associated with which diseases?

A

Ulcerative colitis (80% of PSC patients)
Crohn’s (rarely)
HIV

34
Q

Complications of PSC?

A

Cholangiocarcinoma (10%)

Colorectal cancer risk

35
Q

What is Charcot’s triad? What disease is it associated with?

A

RUQ pain, fever and jaundice

Ascending cholangitis

36
Q

Management of ascending cholangitis

A

IV antibiotics

ERCP after 24-48 hrs to relieve obstruction

Surgery (21 decks)

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