Gastroenterology & Hepatology — Flashcards

Flashcard 361: What is the second-line investigation for acute cholecystitis if ultrasound is inconclusive? _____

Answer: HIDA scan

Flashcard 362: On examination, _____ has a +ve Murphy's sign which is when the examiner instructs the patient to breathe out, then palpates gallbladder (RUQ), instructs the patient to breathe in, which causes inspiratory arrest because of gallbladder pain as the diaphragm pushes gallbladder down into palpated hand

Answer: acute cholecystitis

Flashcard 363: Acute cholangitis LFTs will present with ↑ _____, γ-GT, ALP, & ALT

Answer: bilirubin

Flashcard 364: What is the mainstay management of appendicitis? _____ + administration of IV antibiotics

Answer: Appendicectomy (laparoscopic > open approach)

Flashcard 365: What is the definitive management for ascites caused by cirrhosis? _____

Answer: Liver transplantation

Extra: Management ladder for cirrhotic ascites: 1. Sodium restriction & Diuretics (Spironolactone + Furosemide) 2. Large Volume Paracentesis (LVP) 3. TIPS (for refractory cases) 4. Liver Transplant (Definitive)

Flashcard 366: Acute cholecystitis RUQ pain may radiate to the _____ because of phrenic nerve irritation

Answer: R shoulder

Flashcard 367: Appendicitis most commonly occurs at ages _____ years.

Answer: 10-19

Flashcard 368: 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).

Flashcard 369: What is the management for large, or refractory ascites? _____

Answer: Therapeutic paracentesis

Flashcard 370: What are the risk factors for pigmented gallstones? _____

Answer: Haemolytic disease (particularly hereditary spherocytosis & sickle cell disease)