UW intrahepatic cholestasis and cholelithiasis 12-19 (2)

Question 1

cholestasis. CP. when occurs?

Answer 1

in 3rd trimester

Question 2

cholestasis. CP. pruritus? 3

Answer 2

generalized pruritus
pruritus worse on hands and feet
no associated rash

Question 3

cholestasis. CP. pain?

Answer 3

RUQ pain

Question 4

cholestasis. lab. biles?

Answer 4

incr. total bile acids (>10 umol/l)

Question 5

cholestasis. lab. transaminases?

Answer 5

incr. transaminases (<2x normal)

Question 6

cholestasis. lab. bilirubin?

Answer 6

+/- incr. total and direct bilirubin

Question 7

cholestasis. obstetric risks, 4?

Answer 7

intrauterine fetal demise
preterm delivery
meconium-stained amniotic fluid
neonatal respiratory distress syndrome

Question 8

cholestasis. management? 3

Answer 8

delivery at 37 weeks gestation
ursodeoxycholic acid
antihistamines

Question 9

symptomatic cholelithiasis. patho? 2

Answer 9

incr. biliary cholesterol excretion (estrogen)
decr. gallbladdder motility (progesterone)

Question 10

symptomatic cholelithiasis. patho. what hormone:incr. biliary cholesterol excretion?

Answer 10

estrogen

Question 11

symptomatic cholelithiasis. patho. decr. gallbladdder motility?

Answer 11

progesterone

Question 12

symptomatic cholelithiasis. CP?

Answer 12

recurrent, postprandial epigastric/RUQ pain
RUQ UG with echogenic foci (stones or sludge)

Question 13

symptomatic cholelithiasis. Mx? 2

Answer 13

conservative (eg pain control)
Cholecystectomy (for complicated, recurrent cases)