SG Abdominal Pain Flashcards
Diseases that you test for:
AMA
ANA
AMA = PBC ANA = AI hepatits
Best test for PSC
MRCP
Who can you give bear bile (urosdiol) to?
PBC
What disease has the physical exam finding for rebound tenderness? Or bumping their bed to elicit pain?
Peritonitis
Top 3 differential infections for gall stones
Acute cholecystitis = inflam of GB
- Biliary colic would be a more mild of this
Ascending cholangitis = infection of bile duct due
Acute pancreatitis
Treat gall stones
1** Lap cholecystectomy
- Oral bile salts - dissolves stones but not for acute cholecystitis b/c takes months to work and have to be able to get into GB
- Contact dissolution
- Extracorporial lithotripsy - sound waves
Does chronic pancreatitis give you fever?
No
Acute
What is a cholangiogram?
Image of bile duct
Choledocholithiasis
Common bile duct stones
Doesn’t directly cause fever or ab pain
What is an MRCP?
MRI of bile and pancreatic ducts
Best to see gall stones
What is an ERCP?
Endoscopic retrograde cholangiopancreatography
How you can remove gall stones non-surg
What do you do about asymptomatic gall stones?
Watch!
Which pts are eligible for a prophylactic cholecystectomy? Aka asymptomatic stones
Kids
CF pts
Porcelain (calcified) GB - b/c increased risk cancer
Stones > 3cm b/c won’t pass on own
What is the criteria to det the severity of pancreatits?
Ranson’s criteria
Apache score
NOT amylase or lipase
Supportive care for uncomp pancreatitis
NPO
A lot of IV fluids
Pain meds IV
