GI problems 2

Question 1

what does colicy pain suggest?

Answer 1

-somethign is blocked

Question 2

Cholecystitis

-symptoms

Answer 2

inflammation of the gall bladder

• fever, increase WBC
• pain in RUQ, guarding
• murphys sign

-Ultrasound - may have gallstones, also fluid around the gallbladder

Question 3

How to gall stones form?

Answer 3

• when there is decrease bil movement, can get cholesterol gall stones form in gall bladder
• pigment stones in duct

Question 4

What initiates the emptying of the gall bladder?

Answer 4

-cholecystokinin

Question 5

definitons 
Gallstones
• Biliary colic
• Cholelithiasis
• Cholecystitis
• Choledocholithiasis
• Cholangitis
• Cholesterol stones (80%)
• Pigment stones

Answer 5

pain - biliary colic - type of pain that causes obstruction to gall bladder or bilary system
Cholelithiasis - means gallstones in gallbladder
Cholecystitis - inflammation of gallbladder
Choledocholithiasis - stone in bile duct
cholangitis - when you have choledocholithiasis and infection - fever ect. and infecte blocked ducts
Cholestasis - reduced bile flow out of liver

Question 6

Signs of cholestasis

Answer 6

• elevated GGT, alkaline phosphate, bilirubin
• common bile duct - dilated on ultrasound, develops high fever and rigors
• reduced bile flow out of liver, and colangitis (stone in bile duct and inflammation)
• consequences - can get pancreatitis

Question 7

causes for increase GGT and ALP

Answer 7

• stones
• biliary disease - Primary biliary cirrhosis, primary sclerosing cholangitis
• drugs
• tumours

Question 8

primary and secondary duct stone - choledocholithiasis

Answer 8

• primary - pigment

- secondary - cholesterol

Question 9

what are symptoms of cholangitis

Answer 9

• charcots triad
• fever
• jaundice
• RUQ pain

Question 10

What can you do to test call bladder and bilary tree

Answer 10

=MRCP

Question 11

treatment

Answer 11

can have a cholecystectomy

Question 12

How can you deterine if pnacreatic cancer is the obstruction or not?

Answer 12

if pancreatic cancer is the obstruction then will get weight loss as well and probably wont have murphys sign or garding
-would maybe feel a mass in abdomen, may look wasted

Question 13

why is clotting time checked? and what does this mean?

Answer 13

• clotting time is checked prior to an interventional procedure to relieve his obstruction
• found to have elevated prothrombin time - due to decrease fat malabsorpriton due to blockage of bile, so decrease amount of vitamin absorption

Question 14

Liver function tests for outside of the liver

Answer 14

• GGT and ALP and billirubin increased
• cholestasis
• choledocholithiasis

Question 15

Primary bilary cirrhosis

Answer 15

autoimmune attack of bile cells in liver, bile can leak into blood and damage liver cells (intrahepatic)

• can cause cholestasis, obstructive jaundice
• can get jaundice
• also can get increase cholesterol
• can get itchy skin - early itchiness before jaundice
• get GGT and ALP increase because these are in bile duct cels, and then can also get liver damage due to this

Question 16

Primary sclerosisng cholangitis

Answer 16

• hardening of tissue of extrahepatic ducts and intra hepatic
• autoimmune disease
• obstructive jaundice, bile can leak out into bloodstream

Question 17

how to test for coeliac disease

Answer 17

-igA tissue transglutaminase antibodies is most common

Question 18

*** 3 conditions associated with coeliac disease

Answer 18

• skin conditions - dermatitis
• 1s degree relative with coeliac disease
• type 1 diabetes