Biliary Disease: Approach & Management
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Questions and Answers

What are the baseline investigations recommended for suspected biliary malignancies?

  • CBC, electrolytes, and kidney function (correct)
  • CBC and liver function tests
  • Liver function tests and biliary excretion products
  • Liver function tests and tumour markers

Which imaging modality is specifically used to assess the pancreas in suspected pancreatic cancer?

  • ERCP or PTC
  • CT pancreas protocol (correct)
  • MRI liver
  • CT chest

What is the primary purpose of ERCP or PTC in the investigation of biliary malignancies?

  • To assess for metastases
  • To biopsy mass or lymph node
  • To relieve biliary obstruction (correct)
  • To collect histological samples

Which tumour marker is associated with pancreatic cancer?

<p>CA 19-9 (D)</p> Signup and view all the answers

What is the general prognosis described for patients with pancreatic and biliary cancers?

<p>Shitty prognoses and survival rates (D)</p> Signup and view all the answers

In suspected cholangiocarcinoma, what procedure involves brushing the bile duct to collect samples for histology?

<p>ERCP or PTC (A)</p> Signup and view all the answers

What is the main treatment approach for pancreatic and biliary cancers?

<p>Resect if possible, systemic therapy otherwise (C)</p> Signup and view all the answers

What is a common symptom triad seen in cholangitis, which includes fever, RUQ pain, and jaundice?

<p>Fever, RUQ pain, and jaundice (D)</p> Signup and view all the answers

Which imaging technique is considered the gold standard for diagnosing and treating choledocholithiasis?

<p>Endoscopic retrograde cholangiopancreatogram (ERCP) (A)</p> Signup and view all the answers

What is a significant risk factor for biliary malignancies?

<p>Chronic inflammation of the biliary tree (D)</p> Signup and view all the answers

In gallstone pancreatitis, what causes inflammation and pain in the pancreas?

<p>Blockage of the pancreatic duct by gallstones (A)</p> Signup and view all the answers

What investigation is preferred if there is uncertainty in diagnosing gallstones and acute cholecystitis following an ultrasound?

<p>HIDA scan (A)</p> Signup and view all the answers

Which imaging method can assess for CBD stones and biliary strictures non-invasively without using radiation or anesthesia?

<p>MRCP (A)</p> Signup and view all the answers

What is considered the best diagnostic test for gallstones with 90% specificity but can lead to false negatives in certain conditions?

<p>RUQ ultrasound (D)</p> Signup and view all the answers

Which surgical procedure is considered the gold standard for gallbladder stones?

<p>Cholecystectomy (D)</p> Signup and view all the answers

What is the primary lining of the gallbladder and biliary tree?

<p>Cholangiocytes (B)</p> Signup and view all the answers

Which condition is closely associated with biliary cancers?

<p>Primary sclerosing cholangitis (A)</p> Signup and view all the answers

What are common symptoms of cholangiocarcinoma?

<p>Jaundice and generalized itching (C)</p> Signup and view all the answers

What is the elective surgical treatment for biliary colic?

<p>Cholecystectomy (B)</p> Signup and view all the answers

Which of the following is a risk factor for biliary malignancies?

<p>Obesity (D)</p> Signup and view all the answers

How is cholangiocarcinoma typically diagnosed?

<p>Imaging studies and biopsy (D)</p> Signup and view all the answers

Which of the following substances can contribute to the formation of mixed pigmented gallstones?

<p>Bilirubin breakdown products (D)</p> Signup and view all the answers

What is the most common cause of gallstones in the general population?

<p>Cholesterol precipitates (C)</p> Signup and view all the answers

Which symptom is classically associated with gallstones?

<p>RUQ abdominal pain after eating greasy food (B)</p> Signup and view all the answers

What is the main risk factor for gallstone disease?

<p>Obesity (B)</p> Signup and view all the answers

In the context of biliary malignancies, which presentation is suggestive of cholangiocarcinoma?

<p>Jaundice and weight loss (C)</p> Signup and view all the answers

What is the recommended investigation for suspected cholangiocarcinoma?

<p>Endoscopic retrograde cholangiopancreatography (ERCP) (B)</p> Signup and view all the answers

Which treatment modality is commonly used for pancreatic and biliary cancers?

<p>Surgical resection (A)</p> Signup and view all the answers

What is the term for gallstones hanging out in the gallbladder without causing any problems?

<p>Cholelithiasis (A)</p> Signup and view all the answers

Which of the following is a risk factor for pigment gallstones?

<p>Cirrhosis (C)</p> Signup and view all the answers

What is the typical duration of pain in biliary colic?

<p>&lt; 6 hours (D)</p> Signup and view all the answers

Which condition presents with gallstones in the common bile duct?

<p>Choledocholithiasis (B)</p> Signup and view all the answers

What is a common medication known to cause gallstones?

<p>Hormones &amp; oral contraceptives (D)</p> Signup and view all the answers

What is the term for inflammation of the gallbladder that does not resolve like biliary colic?

<p>Cholecystitis (C)</p> Signup and view all the answers

What is a common presentation of cholangiocarcinoma?

<p>Jaundice and weight loss (D)</p> Signup and view all the answers

What is a common investigation for suspected cholangiocarcinoma?

<p>ERCP (Endoscopic Retrograde Cholangiopancreatography) (C)</p> Signup and view all the answers

Which of the following is a treatment option for pancreatic cancer?

<p>Surgery or chemotherapy (C)</p> Signup and view all the answers

What is a common treatment approach for biliary cancers?

<p>Surgical resection or liver transplant (D)</p> Signup and view all the answers

Which of the following substances contribute to the formation of mixed pigmented gallstones?

<p>Bile salts (D)</p> Signup and view all the answers

In biliary malignancies, which presentation is suggestive of cholangiocarcinoma?

<p>Jaundice and pruritus (A)</p> Signup and view all the answers

Which medication is known to cause gallstones?

<p>Ceftriaxone (C)</p> Signup and view all the answers

Which imaging modality is used to assess the pancreas in suspected pancreatic cancer?

<p>EUS (D)</p> Signup and view all the answers

Which of the following is a risk factor for biliary malignancies?

<p>Obesity (D)</p> Signup and view all the answers

What is the relationship between cholesterol and bile salts in gallstone formation?

<p>Bile salts increase cholesterol solubility in bile (A)</p> Signup and view all the answers

Which of the following imaging methods can assess for metastases in suspected pancreatic cancer?

<p>CT chest, abdo, pelvis (A)</p> Signup and view all the answers

Which imaging modality is considered the gold standard for both diagnosing and treating choledocholithiasis?

<p>ERCP (B)</p> Signup and view all the answers

What imaging technique is specifically recommended to assess for common bile duct (CBD) stones and biliary strictures non-invasively, without using radiation or anesthesia?

<p>MRCP (B)</p> Signup and view all the answers

Which medication is commonly known to cause gallstones?

<p>Ceftriaxone (D)</p> Signup and view all the answers

What presentation type is typically suggestive of cholangiocarcinoma in the context of biliary malignancies?

<p>Painless jaundice (D)</p> Signup and view all the answers

What is the primary purpose of Endoscopic Retrograde Cholangiopancreatography (ERCP) or Percutaneous Transhepatic Cholangiography (PTC) in the investigation of biliary malignancies?

<p>Histological sampling (A)</p> Signup and view all the answers

Which substance can significantly contribute to the formation of mixed pigmented gallstones?

<p>Bilirubin (C)</p> Signup and view all the answers

What is considered the best diagnostic test for gallstones with 90% specificity but can lead to false negatives under certain conditions?

<p>Ultrasound (C)</p> Signup and view all the answers

Which of the following is a risk factor for gallstone disease as described in the text?

<p>High levels of calcium in the bile (A)</p> Signup and view all the answers

What is a possible clinical presentation of gallstones according to the text?

<p>RUQ abdominal pain after eating greasy food (B)</p> Signup and view all the answers

According to the information provided, what role does cholesterol play in the formation of gallstones?

<p>Cholesterol precipitates to form gallstones (A)</p> Signup and view all the answers

Which medication, as indicated in the text, is known to cause gallstones?

<p>Oral contraceptives (D)</p> Signup and view all the answers

What imaging technique is suggested in the text for assessing CBD stones and biliary strictures non-invasively?

<p>MRI scan (D)</p> Signup and view all the answers

What is a plausible risk factor for gallstone disease based on the text?

<p>Biliary obstruction such as bile duct strictures (B)</p> Signup and view all the answers

What is a risk factor for biliary malignancies according to the text?

<p>Obesity (C)</p> Signup and view all the answers

What type of presentation is usually associated with cholangiocarcinoma in its early stages?

<p>Jaundice (B)</p> Signup and view all the answers

Which medication, as per the text, is known to contribute to the formation of gallstones?

<p>Estrogen therapy (B)</p> Signup and view all the answers

How is bile related to cholesterol according to the text?

<p>Bile aids in the digestion and absorption of dietary cholesterol (D)</p> Signup and view all the answers

Which imaging method is not invasive and does not use radiation or anesthesia to assess for CBD stones and biliary strictures?

<p>Ultrasound (B)</p> Signup and view all the answers

What is a common symptom associated with gallstones in the text?

<p>Abdominal pain (usually in the RUQ) (C)</p> Signup and view all the answers

Which condition is closely associated with biliary cancers?

<p>Chronic IBD, particularly UC (D)</p> Signup and view all the answers

Which risk factor contributes to the formation of cholesterol gallstones?

<p>Family history (A)</p> Signup and view all the answers

How does dyslipidemia contribute to the formation of gallstones?

<p>By decreasing biliary secretion of cholesterol (C)</p> Signup and view all the answers

Which medication is NOT associated with an increased risk of gallstone formation?

<p>Proton pump inhibitors (D)</p> Signup and view all the answers

What is the primary imaging modality used to diagnose gallstones in the common bile duct?

<p>ERCP (D)</p> Signup and view all the answers

Which presentation is characteristic of choledocholithiasis?

<p>Persistent right upper quadrant pain without vomiting or fever (C)</p> Signup and view all the answers

How does rapid weight loss contribute to the formation of gallstones?

<p>By causing biliary stasis (A)</p> Signup and view all the answers

Which factor increases the risk of pigment gallstones?

<p>History of Crohn's disease (C)</p> Signup and view all the answers

How do hormones and oral contraceptives contribute to gallstone formation?

<p>By increasing biliary secretion of cholesterol (C)</p> Signup and view all the answers

What imaging modality is commonly used to assess for gallstones within the gallbladder?

<p>Ultrasound (B)</p> Signup and view all the answers

What is a possible consequence of biliary colic that transforms into cholecystitis?

<p>Fever and right upper quadrant pain (D)</p> Signup and view all the answers

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