Flashcards in Biliary Disease Deck (26):
How do you differentiate biliary colic from acute cholecystitis?
DOES NOT INCLUDE FEVER/RAISED WCC/LOCAL PERITONISM
Investigations in Biliary colic (5, bloods all count as 1)
Bloods (LFTs, INR, FBC)
How to manage biliary colic?
Key symptoms of chronic cholecystitis?
Investigation for chronic cholecystits?
Three risk factors for acute cholecystiits?
Gallstones, Obesity, rapid weight los
What is Murphy's sign?
Murphy’s sign - Two fingers on RUQ and ask patient to take deep breath in. Pain & arrest of inspiration is positive.
4 investigations for acute cholecystitis?
Management acute cholecystitis?
What are 5 symptoms of ascending cholangitis?
Three bacteria which cause ascending cholangitis
Klebsiella spp., Escherichia coli, Enterobacter spp
Blood tests for ascending cholangitis (5)
FBC (raised WCC)
ESR & CRP
Imaging for ascending cholangitis (3)
Contrast enhanced CT
What is primary biliary cirrhosis? (which bit of liver does it effect?)
Autoimmune disorder of biliary system involving destruction of canals of Hering (interlobular bile ducts). Causes intrahepatic cholestasis.
Give four core symptoms of PBC
What are 3 signs of PBC
Hepatomegaly occurs in 25%.
Hyperpigmentation occurs in 25%.
Splenomegaly occurs in 15%.
Jaundice occurs in 10%.
Xanthelasma may occur in the later stages.
What core super important antibody is involved in PBC?
What tests would you do in PBC other than antibody screening?
Two possible treatment for PBC
Symptomatic - cholestyramine for pruritus
What autoimmune conditions are associated with PBC?
What is primary sclerosing cholangitis associated with
Inflammatory bowel disease!¬
What part of the liver does primary sclerosing cholangitis effect?
Intra- and extra- hepatic bile ducts
Give four key symptoms of PSC
Fatigue, weight loss, shivers
What is raised in PSC that isn't raised in PBC?
Investigations for PSC?
IgG & IgM