Liver Flashcards
Types of gallstones
- Cholesterol - most common
- Pigment (bilirubin and calcium salts)
- Mixed
Risk factors for gallstone
5 F’s
Female
Fat
Fertile
Forty
Fair
Imaging of gallbladder
Ultrasound
Curative treatment of biliary colic/acute cholecystitis
Laparoscopic cholscystectomy
Difference in symptoms and signs between biliary colic and acute cholecystitis
Acute cholecystitis - pain >6hrs, radiates to R scapula, febrile, Murphy’s sign
Biliary colic - comes and goes after fatty meal, afebrile
Signs and symptoms of acute cholangitis
Charcot’s triad: Fever, RUQ pain and jaundice (due to blockage of common bile duct)
Additional signs and symptoms seen from acute cholangitis progression into biliary sepsis
Charcot’s triad (fever, RUQ pain and jaundice) + altered mental status and hypotension (Reynold’s pentad)
GOLD investigation for acute cholangitis
ERCP
Initial investigation of acute cholangitis
MRCP - due to risks involved in ERCP procecure
Features of primary sclerosing cholangitis
Fibrosis and inflammation of intrahepatic and extrahepatic bile ducts (beads on a string)
More common in males
Associated with UC
Immune mediated condition (T cell attack)
Associated with pANCA and ANA
Autoantibodies associated with primary sclerosing cholangitis
Anti smooth muscle
Anti nuclear
pANCA
GOLD standard investigation for primary sclerosing cholangitis
MRCP - strictures separated by sections of normal bile duct
What is the effect of cholestyramine?
Bile acid sequestrant - relieves symptoms of itching
What is the effect of cholestyramine?
Bile acid sequestrate - relieves symptoms of itching
Features of primary biliary cholangitis
Autoimmune condition leading to destruction of small intrahepatic bile ducts
More common in female
Associated with coeliac, sjogren’s and thyroiditis (autoimmune)
Associated with AMA
