obstructive jaundice Flashcards

1
Q

what tests should you order for someone with suspected jaundice

A

Serum amylase

Prothrombin time

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2
Q

what are the most appropriate radiological investigations

A

US scan first
If answer is unclear - MRCP scan
if both fail to reveal cause - CT scan to exclude other causes

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3
Q

Imaging subsequently confirmed common bile duct gallstones. What treatment options should be discussed to relieve his jaundice?

A

If patient remains well, his jaundice fails to spontaneously resolve, there is a confirmation of galbladder stones and CBD stones - laparoscopic cholecystectomy and simultaneously CBD exploration

ERCP then laparoscopic cholecystectomy after discharge when the patient has recovered

Removal of CBD stones endoscopically - laparoscopic/open cholecystectomy with CBD exploration

open surgery

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4
Q

what is obstructive jaundice

A

Obstructive jaundice is a specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from the bloodstream into the intestines

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5
Q

what are some causes of jaundice (pre/intra/post)

A

prehepatic jaundice - increased production of BR
intrahepatic jaundice - decreased uptake of BR, decreased conjugation, decreased
secretion, decreased outflow - cholestasis
posthepatic jaundice - decreased extrahepatic flow

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6
Q

what is endoscopic retrograde cholangiopancreatography (ERCP)

A

wire inserted from the bottom and take out gallstones using telescope

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7
Q

what is percutaneous transhepatic cholangiography (PTC)

A

a procedure to allow doctors to insert a stent through the skin and liver into the top of the bile duct

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