Liver Flashcards
What is biliary colic?
pain associated with temporary obstruction of cystic or common bile duct
What is acute cholecystitis?
obstructed gallbladder emptying due to gallbladder inflammation
What is ascending cholangitis?
Infected biliary tree due to obstructed bile duct
(due to gallstones, biliary surgery, parasites, or cancer of pancreas head)
What is primary biliary cholangitis (PBC)?
interlobular bile ducts damage by autoimmune inflammation –> cirrhosis
What is primary sclerosing cholangitis (PSC)?
cholestasis with bile duct inflammation + strictures
What is the key difference between PSC + PBC?
PSC: Intrahepatic bile ducts (affected)
PBC: Intrahepatic + extrahepatic bile ducts (affected)
Which doesn’t/don’t have fever/raised WCC?
biliary colic
Which doesn’t/don’t have jaundice?
biliary colic + acute cholecystitis
RUQ pain
No fever/raised WCC
No jaundice
biliary colic
RUQ pain
Fever/raised WCC
No jaundice
acute cholecystitis
RUQ pain
Fever/raised WCC
Jaundice
ascending cholangitis
primary biliary cholangitis (PBC)
primary sclerosing cholangitis (PSC)
+ve Murphy’s sign?
acute cholecystitis
+ve AMA, +ve Jo-1?
primary biliary cholangitis (PBC)
“Beaded” appearance on ERCP?
primary sclerosing cholangitis (PSC)
Ix for biliary colic?
abdo USS
Ix for acute cholecystitis?
abdo exam (+ve Murphy’s)
bloods
abdo USS
Ix for ascending cholangitis?
1st: bloods, abdo USS
Gold: ERCP
Ix for primary biliary cholangitis (PBC)?
1st: bloods (AMA, Jo-1), abdo USS
Gold: liver biopsy
Ix for primary sclerosing cholangitis (PSC)?
ERCP (“beaded”)
What is ursodeoxycholic acid Tx for?
all EXCEPT ascending cholangitis
Tx for ascending cholangitis?
biliary drainage (using ERCP) + IV Abx
Tx for pruritus in PBC + PSC?
cholestyramine
Which is nail polish/hair dye a RFx for?
primary biliary cholangitis (PBC)
Which is associated with xanthelasma + osteoposis?
primary biliary cholangitis (PBC)
Which is associated with UC?
primary sclerosing cholangitis (PSC)
2nd line Tx for gallstones?
shock wave lithotripsy
Gold standard Tx for gallstones?
laparoscopic cholecystectomy
PBC vs PSC: which is a RFx for HCC?
PBC
PBC vs PSC: which is associated with UC?
PSC
(“Please Shit Carefully” = “PSC”)
PBC vs PSC: which is a RFx for cholangiocarcinoma?
PSC
