liver disorders

Question 1

cholestasis

Answer 1

cholestasis - impaired bile formation or flow - fatigue, pruritis, dark urine, pale, jaundice

cholestatic pruritis - can be relieved by colestyramine (most effective), ursodeoxycholic acid, rifampicin (unlicensed)
- can use sertraline and naltrexone (both unlicensed) if previous treatment failed but lots of S.Es

intrahepatic cholestasis in pregnancy
- during late pregnancy - adverse fetal outcomes
- treat pruritis associated with it - ursodeoxycholic acid

Question 2

gallstones

Answer 2

gallstones - hard mineral or fatty deposits forming stones in gallbladder bile duct

majority of patients - asymptomatic
if stones irritate/block gallbladder - pain, infection and inflammation
- if left untreated - complications - cholecystitis, pancreatitis

if symptoms - surgical removal only way

treatment for pain symptoms - paracetamol, NSAIDs for mild to moderate pain
severe pain: IM diclofenac or IM opioid (morphine)

although ursodeoxycholic acid used for gallstone management - no evidence to support its use