Biliary Tract + Pancreatic Disease Flashcards Preview

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Flashcards in Biliary Tract + Pancreatic Disease Deck (36)
1

Women get gallstones more commonly than men. True/False?

True

2

Most people with gallstones are asymptomatic. True/False?

True

3

How do gallstones form?

Abnormal bile composition (usually due to excess cholesterol) causes hardening of bile

4

List some risk factors for developing gallstones (think of the 5 F's)

Female
Forty
Fat
Foetus
Fair (i.e. white skin)
There once was a fat forty-year-old fair female with a foetus.

5

What is acute cholecystitis?

Obstruction of cystic duct by stone causing inflammation of the gall bladder

6

List some investigations for diagnosing gallstones

Ultrasound
CT scan
MRCP/ERCP

7

Outline treatment for acute cholecystitis

IV antibiotics + fluids
Urgent cholecystectomy

8

What is the 2nd most common hepatobiliary cancer?

Cholangiocarcinoma

9

What is the only chance of cure of cholangiocarcinoma?

Surgical resection

10

Severe acute pancreatitis is associated with multi-organ failure and complications. True/False?

True

11

List some obstructive causes of acute pancreatitis

Biliary disease
Pancreatic duct stricture
Tumours of ampulla or pancreas

12

What is the most common toxin that causes acute pancreatitis?

Alcohol

13

List some viral causes of acute pancreatitis

Coxsackie B
Hepatitis
Mumps

14

GET SMASHED is a mnemonic for causes of pancreatitis. What does it stand for?

Gallstones
Ethanol (alcohol)
Trauma
Steroids
Mumps, malignancy
Autoimmunity
Scorpion stings
Hyperlipidaemia, hypercalcaemia
ERCP
Drugs

15

List blood tests that would be done for acute pancreatitis

FBC, U&Es
LFTs
Clotting, CRP
Amylase, glucose, Ca, lipase

16

List imaging that would be done for acute pancreatitis

AXR
Ultrasound
CT scan, MRI
MRCP/ERCP

17

What may be seen on CXR for acute pancreatitis (common exam buzzword)?

Sentinel loop
Also pleural effusion in later stages

18

Glasgow Prognostic Score involves using the mnemonic PANCREAS to assess severity of pancreatitis. How many factors on this score indicate severe pancreatitis?

3 or more factors

19

List typical symptoms of acute pancreatitis

Epigastric pain radiating to the back
Nausea, vomiting
Tenderness
Loss of appetite
Jaundice

20

Hypoglycaemia and hypocalcaemia can complicate acute pancreatitis. True/False?

False
Hyperglycaemia, not hypo, and hypocalcaemia

21

What is a pseudocyst?

Walled-off fluid collection

22

How might a pseudocyst be treated?

Endoscopic or surgical drainage

23

What is involved in a cystgastrostomy?

Create a fistula between the pseudocyst and stomach, so that its contents drain into the stomach

24

Prophylactic antibiotics play a key role in the treatment of acute pancreatitis. True/False?

False
Where used should be short-term defined period

25

What are the 3 major consequences of chronic pancreatitis?

Pain
Endocrine insufficiency
Exocrine insufficiency

26

What is the commonest cause of chronic pancreatitis?

Alcohol abuse

27

What diseases is hereditary chronic pancreatitis associated with?

Cystic fibrosis
a1-antitrypsin deficiency
Hyperparathyroidism

28

What would a CT scan of chronic pancreatitis likely show?

Calcification of pancreas
Dilated pancreatic duct
Fluid collection

29

Outline essential treatment for chronic pancreatitis

Endocrine function - address diabetes
Exocrine function - enzyme supplements (CREON)
Pain - opioids, paracetamol, NSAIDs

30

There are number of specific surgical procedures for chronic pancreatitis - what is the general procedure that is done?

Duodenum/jejunum joined to pancreas to enable pancreatic juice to drain

31

What is the most common cancer of the exocrine pancreas?

Adenocarcinoma

32

List common cancers of the endocrine pancreas

Gastrinoma
Insulinoma
Glucagonoma

33

What does insulinoma cause?

Hypoglycaema (increased insulin causes more glucose storage)

34

What does glucagonoma cause?

Hyperglycaemia (increased glucagon causes more glycogen breakdown)

35

What does gastrinoma cause?

Acid hypersecretion (increased gastrin release)

36

Prognosis of pancreatic cancer is very poor. True/False?

True