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Presents w/ RUQ pains worse after eating as well as N/V, fever, and a
palpable enlarged gallbladder - 🧠 ANSWER ✔✔Acute Cholecystitis
- Cholecystectomy + NPO, IV fluids, antibiotics (Ceftriaxone,
Metronidazole),
,RUQ pain or inspiratory arrest with palpation of the gallbladder is known as
_________ Sign and is indicative of..? - 🧠 ANSWER ✔✔Murphy's sign,
Cholecystitis
R shoulder pains in cases of cholecystitis is known as _________ Sign. - 🧠
ANSWER ✔✔Boas Sign
Diagnosis of acute cholecystitis (initial and gold) - 🧠 ANSWER ✔✔Initial:
U/S
Gold: HIDA
Most common pathogen in acute cholecystitis (and other bile duct
disorders) - 🧠 ANSWER ✔✔E. coli
Presents w/ RUQ pains, jaundice, and fevers. May also have hypotension,
shock, and AMS. Labs show leukocytosis, increased alkaline phosphatase
& GGT, and increased bilirubin. - 🧠 ANSWER ✔✔Acute Cholangitis
- ERCP (diagnostic and therapeutic) + abx
If ERCP is unable to be done, what surgery is indicated for Cholangitis? - 🧠
ANSWER ✔✔Cholecystectomy
,40y/o female presents w/ episodic, abrupt RUQ pain resolving slowly over
minutes as well as nausea made worse with meals. - 🧠 ANSWER
✔✔Cholelithiasis
- Observation +/- ursodeoxycholic acid, cholecystectomy
What is the key demographic most prone to getting
cholelithiasis/choledocholithiasis? - 🧠 ANSWER ✔✔The "5 Fs"
- Fat, fair, forty, female, fertile
Most common source of cholelithiasis stones - 🧠 ANSWER ✔✔Cholesterol
40y/o female presents w/ prolonged RUQ pain as well as N/V made worse
with meals and jaundice. - 🧠 ANSWER ✔✔Choledocholithiasis
- ERCP -> choledocholithotomy
Bilirubin levels of >_____ will cause neonatal jaundice while bilirubin levels
of >_____ will cause neonatal kernicterus. - 🧠 ANSWER ✔✔>5.0 =
Jaundice
>20.0 = Kernicterus
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, Newborn presents w/ jaundice and cerebral dysfunction and
encephalopathy causing seizures, lethargy, irritability, hearing loss, and
mental developmental delays.
- Labs show bilirubin levels >20 mg/dL. - 🧠 ANSWER ✔✔Kernicterus
- Exchange transfusions +/- IVIG
Treatment of neonatal jaundice - 🧠 ANSWER ✔✔Phototherapy +/-
exchange transfusions
Hereditary conjugated bilirubinemia is known as _________ while
hereditary unconjugated bilirubinemia is known as _________ - 🧠
ANSWER ✔✔- Dubin-Johnson Syndrome
- Crigler-Najjar Syndrome
"Dark liver" on liver biopsy alongside asymptomatic bilirubinemia is likely
what diagnosis? - 🧠 ANSWER ✔✔Dubin-Johnson Syndrome
- does not require treatment
Newborn presents w/ jaundice with severe progression in the second week,
leading to kernicterus. Labs show indirect hyperbilirubinemia of 20-
50mg/dL - 🧠 ANSWER ✔✔Crigler-Najjar Syndrome