Term
| Risk Factors for Cholelithiasis: |
|
Definition
- Advancing age
- Female
- Pregnancy
- BCP/estrogen therapy
- Multiparity
- Crohn's disease
- Celiac disease
- Diabetes Meillitus/Glucose Intolerance
- Family history
- Obesity
- Rapid weight loss
- TPN
- Hyperlipidemia
- 4Fs
- Ethnicity
- Pigment stones: Hemolysis, Cirrhosis |
|
|
Term
| Generally if gallstones are asymptomatic, they do not require treatment. What are exceptions to this rule? |
|
Definition
- Those at high risk for GB Carcinoma
- DM b/c greater mortality rate with cholecytsitis
- Sickle Cell Anemia |
|
|
Term
| Those at high risk for GB cancer include: |
|
Definition
- Native American women with gallstones
- Porcelain gallbladder
- Gallstones greater than 3 cm
- Gallbladder polyps greater than 12 mm |
|
|
Term
| Symptomatic cholelithiasis tmt: |
|
Definition
|
|
Term
| choledocolithiasis means the stone is where? |
|
Definition
|
|
Term
| Acute cholecystitis is usually associated with a stone in the __ __. |
|
Definition
|
|
Term
| Lab findings with acute cholecystitis: |
|
Definition
- leukocytosis
- slight increase in alk phosph and trasaminases |
|
|
Term
| Lab findings suggestive of common bile duct obstsruction or pancreatitis: |
|
Definition
- increase in total bilirubin
- increase in amylase |
|
|
Term
|
Definition
- Admission
- IV hydration, NPO
- Antibiotics
- Analgesics
- Cholecystectomy |
|
|
Term
|
Definition
Suggests Acute Ascending Cholangitis
- RUQ pain
- Fever
- Jaundice |
|
|
Term
| Characteristics of acute ascending cholangitis: |
|
Definition
- Charcot's triad
- Hemodynamically unstable
- Increased WBC (eusinophilia) |
|
|
Term
|
Definition
| blockage of sphincter of Oddi |
|
|
Term
| Risk factors for gallbladder cancer: |
|
Definition
- Long history of gallstones
- Chronic cholecysitis
- Lab values suggestive of obstructive jaundice
- Porcelain gallbladder
- Native American
- Mexican American |
|
|
Term
| Cholangiocarcinoma presentation: |
|
Definition
- Painless jaundice
- Acholic stools
- Dark urine |
|
|
Term
| Lab values of cholangiocarcinoma: |
|
Definition
- Akaline phosphatase elevated
- Billirubin elevated
- GGT elevated
- If PSC is present, CA 19-9 elevated |
|
|
Term
|
Definition
| - painless palpable gallbladder seen with Cholangiocarcinoma |
|
|
Term
| Primary Biliary Cirrhosis (PBC) is ___ destruction of __ __ __. Thus, __ leads to ___. More common in ___. |
|
Definition
- autoimmune destruction of intrahepatic bile ducts
- cholestasis
- hepatotoxicity
- females |
|
|
Term
| Symptoms of Primary Biliary Cirrhosis: |
|
Definition
Please Forgive Steve's Xylaphone Of Offending Pete's Judgment.
- Pruritis
- Fatigue
- Steatorrhea
- Xanthoma
- Osteomalacia
- Osteoporosis
- Portal HTN
- Jaundice |
|
|
Term
| Lab and test findings of Primary Biliary Cirrhosis: |
|
Definition
- cholestatic pattern on liver profile- elevated alkaline phosphatase
- + AMA (anti-mitochondrial antibodies)
- Liver biopsy: bile ductular proliferation, fibrosis, cholangitis |
|
|
Term
| Liver biopsy findings consistent with Primary Biliary Cirrhosis: |
|
Definition
- bile ductular proliferation
- cholangitis
- fibrosis |
|
|
Term
| Treatment for Primary Biliary Cirrhosis (PBC): |
|
Definition
CCCAUL
- Corticosteroids
- Cyclosporine
- Cholestyramine
- Azathioprine
- Ursodeoxycholic acid
- Liver transplant |
|
|
Term
| Primary Biliary Cirrhosis (PBC) is more common in __, while Primary Sclerosiing Cholangitis (PSC) is more common in ___. |
|
Definition
|
|
Term
| Non- malignant, non-bacterial, chronic inflammatory narrowing of the hepatic bile duct: |
|
Definition
| Primary Sclerosing Cholangitis |
|
|
Term
| Primary Sclerosing Cholangitis (PSC) is associated with __ __. |
|
Definition
|
|
Term
| PSC increases ones risk of: |
|
Definition
- Cholangiocarcinoma
- Cholangitis
- Colon cancer |
|
|
Term
| With PSC, diagnosis is made via __ or __ in which you would see ___. Staging is then done via __, on which you would see __ __. |
|
Definition
- MRCP or ERCP
- "beading"
- biopsy
- onion skin |
|
|
Term
| Primary Sclerosing Cholangitis tmt: |
|
Definition
CABHL
- Corticosteroids
- Antibiotics
- Biliary stent for strictures
- High dose ursodeoxycholic acid
- Liver transplant- increased risk for biliary strictures, contined risk for colon cancer |
|
|
Term
| Even if a pt gets a liver transplant for PSC, they still have an increased risk of: |
|
Definition
- biliary strictures
- colorectal cancer |
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|
