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Flashcards in Biliary Disease Deck (26):
1

How do you differentiate biliary colic from acute cholecystitis?

DOES NOT INCLUDE FEVER/RAISED WCC/LOCAL PERITONISM

2

Investigations in Biliary colic (5, bloods all count as 1)

Urinalysis
CXR
ECG
Ultrasound
Bloods (LFTs, INR, FBC)

3

How to manage biliary colic?

Cholecystectomy

4

Key symptoms of chronic cholecystitis?

RUQ Pain
Nausea
Vomiting
Fat intolerance
IBS

5

Investigation for chronic cholecystits?

USS
MRCP

6

Three risk factors for acute cholecystiits?

Gallstones, Obesity, rapid weight los

7

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.

8

4 investigations for acute cholecystitis?

FBC
LFTs
Ultrasound
HIDA cholescintigraphy
MRCP

9

Management acute cholecystitis?

Cholecystectom
Laparotomy Cholecystectomy

10

What are 5 symptoms of ascending cholangitis?

Reynold’s Pentad
RUQ pain
Fever
Jaundice
Hypotension
Confusion

11

Three bacteria which cause ascending cholangitis

Klebsiella spp., Escherichia coli, Enterobacter spp

12

Blood tests for ascending cholangitis (5)

FBC (raised WCC)
ESR & CRP
LFTs
U&Es
Amylase

13

Imaging for ascending cholangitis (3)

Ultrasound
Abdominal x-ray
Contrast enhanced CT

14

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.

15

Give four core symptoms of PBC

Fatigue
Pruritius
RUQ
Jaundice later

16

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.

17

What core super important antibody is involved in PBC?

Antimitochondrial antibody

18

What tests would you do in PBC other than antibody screening?

LFTs
IGM
Ultrasound
Cholangiography
Liver biopsy

19

Two possible treatment for PBC

Symptomatic - cholestyramine for pruritus
Liver transplant

20

What autoimmune conditions are associated with PBC?

Coeliac's
CREST
Thyroid

21

What is primary sclerosing cholangitis associated with

Inflammatory bowel disease!¬

22

What part of the liver does primary sclerosing cholangitis effect?

Intra- and extra- hepatic bile ducts

23

Give four key symptoms of PSC

Pruritis
Jaundice
RUQ pain
Fatigue, weight loss, shivers

24

What is raised in PSC that isn't raised in PBC?

Alkaline phosphatase

25

Investigations for PSC?

LFTs
PTT
IgG & IgM
p-ANCA
MRCP
Liver biopsy

26

Management for PSC?

Pruritis
Cholestyramine/Rifampicin/SSRI
Prevent progression
ADEK supplements
Avoid alcohol