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22 Cards in this Set

  • Front
  • Back
Who's at risk for gallstones?
Females
Pima Indians
Mexican-Americans
Oral contraceptives
Estrogen
Long term TPM
What are the symptoms of gallstones?
RUQ pain
Jaundice
Sepsis
What does increased serum amylase indicate?
pancreatitis
What type of bilirubin is elevated with extrahepatic biliary obstruction or cholestasis?
Conjugated bilirubin
What type of bilirubin is elevated with hepatocellular disease
both indirect and direct (unconjugated and conjugated) bilirubin
What is the initial study for evaluating patients with suspected biliary tract disease.
Ultrasound
What test can you do to determine whether the cystic duct is patent?
HIDA Scan
calcification of the gallbladder wall is known as?
Porcelain gallbladder
conjugated (direct) hyperbilirubinemia with predominant alkaline phosphatase elevation suggests?
Extrahepatic biliary obstruction
What tests are available for diagnosing bile duct obstruction not assoc with calculi
PTC-Percutaneous transhepatic cholangiography

ERCP- endoscopic retrograde cholangiopancreatography
A palpable, nontender gallbladder seen in pancreatic cancer is called?
Courvoisier's sign
The most common site of bile duct cancer?
bifurcation of the common hepatic ducts (> 50%)

"Klatskin tumors"
what is the operation of choice for distal common duct tumors?
Whipple procedure
What is the difference in patient presentation with biliary colic vs acute cholecystitis
Biliary colic- pt writhes about
acute cholecystitis- lies completely still, due to imflamed peritoneum
who should have elective cholecystectomies with asymptomatic gallstones?
Diabetics because the clinical course is generally more severe once they develop inflammation of the gallbladder
what causes acute cholecystitis? How do you diagnose it?
acute and persistent obstruction of the cystic duct

Dx with HIDA scan
However initial test is ultrasound
Usually acute cholecystitis is assoc with gallstones; in which pts can it occur without gallstones?
diabetic
immunosuppressed
postoperative pt
What physical sign is usually positive with cholecystitis?
Murphy's sign
what are S/Sx of choledocholithiasis?
Fluctuating jaundice
Acholic stools
Biliuria
What is Charcot's triad?
Fever
Jaundice
Right upper quadrant pain

associated with cholangitis
What is Reynold's pentad?
hypotension and mental confusion in addition to Charcot's triad
What does Reynold's pentad indicate?
Acute suppurative cholangitis (pus under pressure), a surgical emergency.