Gastroenterology & Hepatology — Flashcards

Flashcard 351: _____ acute cholecystitis typically occurs in critically ill patients

Answer: Acalculous

Flashcard 352: Gallstones in different locations can manifst in disease: Biliary colic: _____ Acute cholecystitis: RUQ pain + fever Acute cholangitis: Charcot's triad ± Reynold's pentad Gallstone Pancreatitis: epigastric pain radiating to back

Answer: postprandial RUQ pain

Flashcard 353: What is the definitive management of acute cholangitis?

Answer: Biliary decompression (primarily via ERCP ± sphincterotomy; alternatively PTBD or surgery)

Flashcard 354: On examination, pain in appendicitis localizes to _____ (tenderness at the junction of the lateral 1/3 and medial 2/3 of a line drawn from the right anterior superior iliac spine (ASIS) to the umbilicus).

Answer: McBurney's point

Flashcard 355: Ascitic fluid analysis with neutrophils > 250 cells/ul indicates _____

Answer: spontaneous bacterial peritonitis

Flashcard 356: Median age of acute cholangitis is _____-60 years old

Answer: 50

Flashcard 357: What is the interim management of acute cholecystitis in unstable or clinically deteriorating patients? _____

Answer: Gallbladder draining procedures e.g. percutaneous cholecystostomy

Flashcard 358: Acute cholecystitis affects _____ 3:1 with peak incidence > 50 years old

Answer: females

Flashcard 359: How does pain differ in appendicitis & mesenteric adenitis? _____

Answer: Mesenteric adenitis: more diffuse, can be intermittent, less severe Appendicitis: constant & proressively worsens

Flashcard 360: Investigation of choice for asymptomatic gallstones: _____

Answer: Ultrasonography (USG)

Extra: Asymptomatic gallstones (incidental gallstones) usually require no treatment (Expectant management/Observation). Prophylactic cholecystectomy is only indicated in specific cases (e.g., porcelain gallbladder, stones >3cm, calcified/porcelain gallbladder, or sickle cell anemia).