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GASTRO > Liver, Pancrease, Gallbladder > Flashcards

Liver, Pancrease, Gallbladder Flashcards

1
Q

what type of necrosis occurs in acute pancreatitis?

A

liquifactive hemorrhagic necrosis of the pancrease
fat necrosis of perpancreatic fat

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2
Q

what are the clinical features of acute pancreatitis?

A

epigastric abd pain
nausea and vomit
periumbilical and flank haemorrhage (CULLEN’S AND GREY TURNERS SIGNS)
inc serim lipase
hypocalcemia

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3
Q

what are the complications ass with acute pancreatitis?

A

shock
pancreatic pseudocyst
pancreatic abcess( due to E.COLI)
DIC
ARDS

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4
Q

What are the causes of acute pancreatitis?

A

alc
gallstones
mumps
trauma
hypercalcemia (act the enzymes)
hyperlipidemia
scorpion sting
rupture of post duodenal ulcer
sulfa drugs,diabetes,6MP
ERCP

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5
Q

What histological changes to pancrease occurs in acute and chronic pancreatitis?

A

in acute;
inflammation and hemorrhage of the pancrease
in chronic;
fibrosis of paranchyma ,mostly due to recurrent acute pan

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6
Q

what causes chronic pancreatitis?

A

alc
cystic fibrosii (in children)

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7
Q

what are the clinical features of chronic pancreatitis?

A

epigastric abd pain
pancreatic insufficiency
dystrophic calcification
sec diabetes mellitus
inc risk of Ca

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8
Q

where does pancreatic Ca originates from?

A

an adenocarcinoma arising from the pancreatic ducts

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9
Q

what are the 2 main causes of panc Ca?

A

smoking
chr pancreatitis

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10
Q

what are the clinical features of panc Ca?

A

epigastric abd pain
secondary diabetes mellitus( when tumor in the body or tail of pancrease)
obstructive jaundic( when tumor in the body)
pancreatitis
migratory thrombophlebitis

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11
Q

what is another name for migratory thrombophlebitis?

A

Trousseau syndrome
( swelling ,erythema, tenderness in the extremities)

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12
Q

what’s the serum tumor marker for pancreatic Ca

A

CA 19-9

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13
Q

what is the name of procedure for en bloc removal o carcinoma pancrease?

A

whipple procedure

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14
Q

what is whipple procedure

A

removal of;
head n neck of pancrease
proximal duodenum
gallbladder

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15
Q

what’s courvoisier sign?

A

physical exm finding for pancreatic Ca
enlarged painless gallbladder with jaundice

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16
Q

when does billiary atresia occur

A

first 2 months of life

17
Q

what are the presentations for billiary atresia?

A

jaundice
cirrhosis

18
Q

what are the two types of gallstones?

A

cholesterol stones(yellow, RADIOLUCENT)
bilirubin stones(pigmented, RADIOPAQUE)

19
Q

What are the risk factors for cholesterol gallstones?

A

age in 40a
estrogen
multiple pregnancies( in preg both estrogen and proges inc, so estrogen inc chl syntheisi and proges dec gallbldr emptying)
oral contracepties
clofibrate
Americans
Crohns disease
cirrhosis

20
Q

what are the risk factors for bilirubin gallstones?

A

extravascular hemolysis
biliarry tract infection

21
Q

which organisms are involved in billiary tract infection?

A

ascaris lumbricoides
clonorchis sinensis

22
Q

what re the symptoms of gallstones?

A

gallstone are usually ASYMPTOMATIC, however many complications can occur;
biliary colic
acute and chronic cholecystitis
ascending cholangitis
gallstones illeus
gallbladder cancer

23
Q

where and why dose the billiary colic occurs?

A

its a RUQ Pain
it occurs due to gallbladder contracting against a STONE lodged in the cysic duct

24
Q

how does acute cholecystitis occurs?

A

stone lodged in cystic duct
RUQ pain often radiating to the right scapula

25
Q

what is the presentation of acute cholecystitis pt?

A

fever
inc wbc
nausea
vomiting
inc serum ALP

26
Q

what causes chr cholecystitis?

A

chemical irritation due to longstanding cholelithiasis

27
Q

what is ROKITANSKY ASCHOFF SINUS and which diseaase is it associated with?

A

herniation of gallbladder mucos into the muscula wall and its ass with chr cholecystitis

28
Q

when does cholecystitis pain occur?

A

Vague RUQ pain
occurs after eating

29
Q

what is porcelein gallbladder?

A

shrunken hard gallbladder due to ch inflammation fibrosis and dystrophic calcification in cholecystitis

30
Q

whats the treatment option for chr cholecystitis?

A

cholecystectomy
especially if porcelain gallbladder is present

31
Q

ascending cholangitis

A

bacterial infection of bile ducts
gram neg
sepsis jundice and abd pain
inc incidence with choledocolithiasis( stone in biliary ducts)

32
Q

gallstone illeus

A

cholecystitis>gallbladder wall rupturs> form a fistula bt gallbladder and duodenum>gallstones enter and blocks teh small bowel

33
Q

gallbladeer carcinoma arises from

A

adenocarcinoma arising from glandular epithelium that lines gallbladder wall
classically present as cholecystitis in an elderly woman

34
Q

what are the xray findings of gallstone illeus?

A

air in the biliary tree(normally filled with bile)

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36
Q
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GASTRO (2 decks)

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