Term
| When doing bile acid replacement what bile acid is used |
|
Definition
| Ursodeoxycholic Acid-least toxic |
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|
Term
| What are the major types of Gallstones |
|
Definition
Cholesterol: Pure is large and white
Black: Calcium complex with uncongugated bilirubin
Brown: Enteric colonization |
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Term
| What population gets more pigmented gall stones? |
|
Definition
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|
Term
| What is Mirizzi's Syndrome and how does it present? |
|
Definition
Stone in Cystitic duct
Presents like Common bile duct obstruction
Elevated Billirubin and Liver enzymes
|
|
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Term
| What is Charcot's Triad and what does it indicate |
|
Definition
Triad
Pain
Jaundice
Fever
Indicates Cholangitis |
|
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Term
| What is the presentation of Biliary colic |
|
Definition
| RUQ Pain increasing over 30 min for 1-5 hrs |
|
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Term
| What is the presentation of Acute Cholecystitis |
|
Definition
History of biliary colic
RUQ pain for >6 hours
Maybe: Fever, Leukocytosis |
|
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Term
| What is Murphy's Sign and what is it a sign of |
|
Definition
RUQ pain on deep inspiration
Sign of Acute Cholecystitis |
|
|
Term
| What are the signs of Choledocholithiasis |
|
Definition
Jaundice
Elevated Bilirubin and Liver enzymes
Perhaps pancreatitis depending on location |
|
|
Term
| What is the Presentation of Cholangitis |
|
Definition
Charcot's Triad: Pain, Jaundice, Fever
Fever, Hypotension |
|
|
Term
| What is the presentation of pancreatitis from choledolithiasis? |
|
Definition
Pain radiates straight to the back
Elevation of Lipase and Amylase
Jaundice
Elevated liver enzymes |
|
|
Term
| What is the presentation of Acalculous Cholecystitis |
|
Definition
RUQ pain in a severely ill pateint(ICU)
(Incfection, Burns, Diabetes, Infection Gallbladder) |
|
|
Term
What is the cause of porcelein bladder?
What is the risk |
|
Definition
Calcification of Gallbladder wall
Increase risk of Gallbladder carcinoma |
|
|
Term
What is the cause of Gallstone ileus?
How does it present? |
|
Definition
Large stone causing gallbladder duodenal fistula
Present: Ileocecal valve obstruction-> Distention of small bowel
|
|
|
Term
| What enzyme is most sensitive to biliary irritation and which is most specific? |
|
Definition
ALP: Most specific
GGTP: Most sensitive |
|
|
Term
What is the indication if the AST: ALT ratio is:
High
Low |
|
Definition
High: alcohol
Low: Viral hepatitis |
|
|
Term
What is the most sensitive test for gall stones?
What test is best for Acute Cholecystitis?
What test is Choledocholithiasis? |
|
Definition
Ultrasound
Acute Chole: HIDA(Hepatobiliary Scintigraphy)
Choledocholithiasis: ERCP(Endoscopic Retrograde Cholecystipancreatography) |
|
|
Term
| What location of Cholangiocarcinoma has a better prognosis? |
|
Definition
|
|
Term
What is the presentation of Ampulla cancer
What is this presentation similar to? |
|
Definition
Pancreatitis
Silver Stool
Courvoisier Sign:
Painless Jaundice(doesn't irritate gallbladder)
Palpable Gallbladder
Similar: Pancreatic Adenocarcinoma in the head |
|
|
Term
What sex is more commonly affected in
Primary biliary Cirrhosis
Primary Sclerosing Cholangitis
What other diseases are they associate with |
|
Definition
Primary biliary Cirrhosis:
Women
Anti-mitochondrial AB, Other Autoimmune diseases
Primary Sclerosing Cholangitis
Men
Ulcerative Colitis |
|
|
Term
| What hormone is most potent stimulator of gallbladder motility? |
|
Definition
|
|
Term
| What is the most common presentation of PBS? |
|
Definition
Fatigue
Increased ALP w/o elevated liver enzymes
Pruritis
Jaundice
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