Gall bladder and bile duct

Question 1

Risk factors of gall stones

Answer 1

Fat
Female
(Forty)
Fertile

Question 2

Describe biliary colic gallstones

Answer 2

when gallstone is impacted in the gallbladder neck temporarily and is dislodged back into the gallbladder

Question 3

Describe acute cholecystitis

Answer 3

when the gallstone is stuck in the gallbladder neck and causes inflammation

Question 4

Presentation of acute cholecystitis

Answer 4

RUQ pain, fever, nausea and vomiting

Murphy’s sign

Question 5

Investigations of acute cholecystitis

Answer 5

US Scan abdomen

LFTs to exclude liver/bile duct pathology

Question 6

Treatment of acute cholecystitis

Answer 6

Laproscopic cholecystectomy

Supportive - analgesia, fluids if needed

Question 7

What is ascending cholangitis

Answer 7

Gallstone is stuck in Common Bile Duct
The flow of bile prevents intestinal bacteria from migrating up the biliary tree and this process is stopped due to the gallstone

Question 8

Common bugs in ascending cholangitis

Answer 8

E. coli, klebsiella, enterococcus (group D strep)

Question 9

Ascending Cholangitis:

What is Charcot’s triad and what is Reynold’s Pentad

Answer 9

Charcot’s triad: Fever, RUQ pain, Jaundice

Reynold’s Pentad: Hypotension and confusion

Question 10

Investigations of ascending cholangitis

Answer 10

US scan abdomen

NRCP to locate stone

Question 11

Treatment of ascending cholangitis

Answer 11

ERCP to remove stone