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40 Cards in this Set

  • Front
  • Back
gallstones are ___th leading GI cause of hospitalization
1st
gallstones are more common in M/F
F
cholesterol gallstones comprise ___% of all gallstones
85
4 causes of cholesterol gallstones from hypomotility
weight loss
TPN
pregnancy
somatostatin analogues
___ is a somatostatin analog
octreotide
__ is an antibiotic which can cause cholesterol gallstones by ___ing
ceftriaxone
precipitating as a salt
___s can cause cholesterol gallstones by increasing cholesterol ___
oral contraceptives
secretion
pigment stones comprise ___% of gs, but incidence is higher in ___ like ___
15
asian countries
japan
main salt in pigment stone is ___
ca bilirubinate
2 risk factors for pigment stones
hemolytic disease
ileal disease
___% of cholelithiasis is symptomatic
15
recurrence rate after 1st episode of biliary colic
70%
4 absolute indications for prophylactic cholecystectomy in asymptomatic cholelithiasis
polyps>1cm present
porcelain gallbladder
high risk population for gallbladder ca
gs>=3cm
5 relative indications for prophylactic cholecystectomy in asymptomatic cholelithiasis
chronic hemolysis
DM
incidental cholecystecomy
gastric bypass for morbid obesity
transplant patients
abd xray has high/low sensitivity & specificity for gs
low
abd xray can show you (5)
calcifications in pancreatitis
ileus
perforation
intestinal pneumatosis
pneumonia
___ is the imaging modality of choice for gs
US
sensitivity and specificity of US for stones>2mm
95%
in cholecystectomy, ___ is removed and ___ is double clipped
gallbladder
cystic duct
conservative tx for biliary colic is ___. ___ rate is high with cessation of drug
UDCA
recurrence rate
acute calculous cholecysititis is caused by __, not ___.
gs
bacteria
bacteria are present in bile of ___% acute cholecystitic patients, most commonly ____.
50
e coli
___% of acute cholecystitic patients had previous colic
75
leukocytosis in acute cholecystitis is mild/severe
mild
when jaundice is severe in acute cholecystitis, it suggests (3)
choledocholithiasis (CBD stones)
cholangitis
common hepatic duct stone
2 US findings in acute cholecystitis
gb wall thickening
pericholecystic fluid
if US is non-diagnostic, do ___
HIDA
conservative tx of acute calculous cholecystitis (3)
fluids
NPO
IV antibiotics
surgery for acute calculous cholecystitis (ACC) is indicated if ___
patient fails to improve with conservative tx
surgery for acute calculous cholecystitis
cholecystectomy
surgery for ACC patients not eligible for cholecystectomy
percutaneous cholecystostomy
5 complications of ACC
empyema
emphesymatous cholecystitis
gangrene/perforation
cholecystoenteric fistula
gallstone ileus
obstruction in gallstone ileus is most commonly at ___ (2)
ileum
sigma
acute acalculous cholecystitis (AAC) occurs in ___ patients. it is caused by ___ (2).
critically ill
stasis
visceral ischemia
most common cause of extrahepatic obstructive jaundice is ___
choledocholithiasis
AAC accounts for ___% of acute cholecystitis
it follows a ___ course
5--10
fulminant
3 kinds of causes of obstruction in choledocholithiasis
stone
malignancy
benign stricture
3 kinds of obstructive malignancy causing choledocholithiasis
GB ca
bile duct ca (Klatskin)
mets
2 kinds of benign stricture causing choledocholithiasis
sclerosing cholangitis
PBC
3 complications of choledocholithiasis
cholangitis (esp e coli)
gs pancreatitis
liver disease