Passmedicine Flashcards
Features of biliary colic
Colicky abdominal pain, worse postprandially, worse after fatty foods
May radiate to the right shoulder
Nausea and vomiting are common
What condition is associated with pigmented gallstones?
Sickle cell
(this is because sickle cell anaemia results in increased red cell haemolysis and thus pigmented gallstones)
Pigmented gallstones are associated with haemolytic anaemia and liver cirrhosis
What is whipples procedure
Operation to remove the head of the pancreas
Why do you need to sort out jaundice?
Patients with unrelieved jaundice have a much higher incidence of septic complications, bleeding and death
What is murphys sign?
You hook your fingers under the liver border and ask the patient to breath in -on inspiration the gallbladder will descend onto the fingers - in acute cholecystitis this will cause the patient to jump because it will be sore
Why are patients with Crohn’s more likely to develop bile duct stones?
Normally bile salts are absorbed in the terminal ileum.
In Crohn’s, absorption is impaired and so they may develop bile duct stones - these can pass into the common bile duct and cause obstructive jaundice
This bacteria causes chronic diarrhoea in immunocompromised patients
Mycobacterium avium complex
Most common causative organism of ascending cholangitis
E. coli
then followed by Klebsiella
What is Lemierre syndrome?
Starts with sore throat and fever - bacteria then spread through the lymphatic vessels
Internal jugular then swells and pus-containing tissue moves from the original location to other organs (most commonly the lungs)
Which bacteria causes Lemierre syndrome?
Fusobacterium necrophorum
Isograft
Transplant to identical twin
Autograft
Transplanting a tissue in your body to a different site (e.g. using saphenous vein for coronary artery bypass)
Allograft
When you donate e.g. a kidney to another human
Duodenal ulcers and eating
Pain relieved by eating
Gastric ulcers and eating
Pain worsened by eating
