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</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</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</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</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</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)</p> Signup and view all the answers

    What is a significant risk factor for biliary malignancies?

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

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

    <p>Cholecystectomy</p> Signup and view all the answers

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

    <p>Cholangiocytes</p> Signup and view all the answers

    Which condition is closely associated with biliary cancers?

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

    What are common symptoms of cholangiocarcinoma?

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

    What is the elective surgical treatment for biliary colic?

    <p>Cholecystectomy</p> Signup and view all the answers

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

    <p>Obesity</p> Signup and view all the answers

    How is cholangiocarcinoma typically diagnosed?

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

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

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

    Which symptom is classically associated with gallstones?

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

    What is the main risk factor for gallstone disease?

    <p>Obesity</p> Signup and view all the answers

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

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

    What is the recommended investigation for suspected cholangiocarcinoma?

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

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

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

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

    <p>Cholelithiasis</p> Signup and view all the answers

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

    <p>Cirrhosis</p> Signup and view all the answers

    What is the typical duration of pain in biliary colic?

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

    Which condition presents with gallstones in the common bile duct?

    <p>Choledocholithiasis</p> Signup and view all the answers

    What is a common medication known to cause gallstones?

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

    What is a common presentation of cholangiocarcinoma?

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

    What is a common investigation for suspected cholangiocarcinoma?

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

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

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

    What is a common treatment approach for biliary cancers?

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

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

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

    In biliary malignancies, which presentation is suggestive of cholangiocarcinoma?

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

    Which medication is known to cause gallstones?

    <p>Ceftriaxone</p> Signup and view all the answers

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

    <p>EUS</p> Signup and view all the answers

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

    <p>Obesity</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</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</p> Signup and view all the answers

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

    <p>ERCP</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</p> Signup and view all the answers

    Which medication is commonly known to cause gallstones?

    <p>Ceftriaxone</p> Signup and view all the answers

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

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

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

    <p>Bilirubin</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</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</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</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</p> Signup and view all the answers

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

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

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

    <p>Obesity</p> Signup and view all the answers

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

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

    Which condition is closely associated with biliary cancers?

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

    Which risk factor contributes to the formation of cholesterol gallstones?

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

    How does dyslipidemia contribute to the formation of gallstones?

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

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

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

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

    <p>ERCP</p> Signup and view all the answers

    Which presentation is characteristic of choledocholithiasis?

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

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

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

    Which factor increases the risk of pigment gallstones?

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

    How do hormones and oral contraceptives contribute to gallstone formation?

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

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

    <p>Ultrasound</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</p> Signup and view all the answers

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