UW intrahepatic cholestasis and cholelithiasis 12-18 (1) Flashcards
cholestasis. CP. when occurs?
in 3rd trimester
cholestasis. CP. pruritus? 3
generalized pruritus
pruritus worse on hands and feet
no associated rash
cholestasis. CP. pain?
RUQ pain
cholestasis. lab. biles?
incr. total bile acids (>10 umol/l)
cholestasis. lab. transaminases?
incr. transaminases (<2x normal)
cholestasis. lab. bilirubin?
+/- incr. total and direct bilirubin
cholestasis. obstetric risks, 4?
intrauterine fetal demise
preterm delivery
meconium-stained amniotic fluid
neonatal respiratory distress syndrome
cholestasis. management? 3
delivery at 37 weeks gestation
ursodeoxycholic acid
antihistamines
symptomatic cholelithiasis. patho? 2
incr. biliary cholesterol excretion (estrogen)
decr. gallbladdder motility (progesterone)
symptomatic cholelithiasis. patho. what hormone:incr. biliary cholesterol excretion?
estrogen
symptomatic cholelithiasis. patho. decr. gallbladdder motility?
progesterone
symptomatic cholelithiasis. CP?
recurrent, postprandial epigastric/RUQ pain
RUQ UG with echogenic foci (stones or sludge)
symptomatic cholelithiasis. Mx? 2
conservative (eg pain control)
Cholecystectomy (for complicated, recurrent cases)