These are signs and symptoms of obstructive, or surgical, jaundice.
What is dark urine, pale colored stool, pruritis, and osteomalacia
100
This organism is most commonly involved with cholangitis.
What is E. coli
Also, Klebsiella, Pseudomonas, B. fragilis, Enterococci
100
Best test to evaluate initially for biliary ductal dilation
What is ultrasound
100
Best test to assess the extent of a pancreatic head mass
What is CTA pancreas protocol
100
In addition to the skin where else may jaundice be appreciated.
What is Sclera, palms of the hands, soles of the feet, mucous membranes.
200
Charcot's triad includes these findings
What is Fever, RUQ pain, Jaundice
200
Name 4 signs and symptoms associated with an increased risk of choledocholithiasis.
What is
1. Jaundice/cholangitis/pancreatitis
2. Dilated CBD
3. CBD stone visualized on imaging
4. Elevate bilirubin, Alk Phos
5. Many small gallstones in the gallbladder
200
The risk of post-ERCP pancreatitis
What is 4-7%
200
Palliative procedure of choice for a tumor obstructing the bile duct
What is self-expanding metal stent
200
Breakdown of hemoglobin leads to this degradation product.
What is unconjugated bilirubin.
300
These findings are needed for a positive Murphy sign.
What is cessation of inspiration during palpation of the gallbladder.
300
80 F from a local nursing home presents with signs and symptoms of an SBO and is noted to have air within the biliary tract. She is in atrial fibrillation with RVR (HR 135), SBP 80's. The diagnosis and steps in management.
What is Gallstone ileus
1. IVF
2. Abx
3. Exploration with enterotomy to remove stone and defer cholecystectomy (+/- fistula takedown and/or cholecystotomy)
300
A patient undergoing a routine RUQ US is found to have a single gallbladder polyp measuring 1.7 cm. This is the appropriate next step.
What is cholecystectomy
300
This is where gallbladder carcinoma spreads first
What is liver segments IV and V and Calot's Node.
300
Effective procedure to reduce pain associated with advanced pancreatic cancer
What is celiac ganglion injection.
400
These are findings consistent with acute cholecystitis seen on ultrasound.
What is
1. Thickened gallbladder wall (>4 mm)
2. Peri-cholecystic fluid
3. Distended gallbladder (>5 cm in transverse diameter)
4. + Sonographic Murphy
5. Impacted stone in cystic duct
400
This is the managment of gangrenous cholecystitis
What is cholecystectomy
400
Initial test for post-cholecystectomy jaundice
What is ultrasound
400
This eponym describes the findings of a non-tender, palpable gallbladder often associated with a tumor and not stone disease.
What is Courvoisier's Law
400
Pathology on one of your recent cholecystectomy patients is significant for gallbladder carcinoma invading the lamina propria of the gallbladder. This is the procedure of choice for further management.
What is no further resection
500
Bilirubin level (mg/dL) at which jaundice becomes evident.
What is 2 mg/dL
500
The role of glucagon in an intraoperative cholangiogram
What is relax the sphincter of Oddi.
Can help differentiate CBD stone from spinchter spasm.
500
What is the role of CCK in HIDA
What is causes contraction of the gallbladder. Can be used to assess EF.
500
70 F presents with gallbladder carcinoma that invades the peri-muscular connective tissue, but not beyond the serosa. This is the preferred management
What is radical cholecystectomy or resection of liver segments IVb and V with lymphadenectomy
500
This eponym describes a small tumor at the confluence of the right and left hepatic ducts.