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Pathology | Medicine (MD/DO) School Study Aid


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Biliary Disorders
16 Picmonics to Learn | 41 mins

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Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
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3 mins
Primary Sclerosing Cholangitis Mechanisms
Mechanism
Unknown Mechanism
"Onion Skin" Fibrosis
"Beading" of Bile Ducts
Symptoms
Pruritus
Hepatosplenomegaly
Jaundice
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2 mins
Primary Sclerosing Cholangitis Labs and Treatment
Labs
Increased Conjugated Bilirubin
Increased ALK-P
Increased IgM
Associated Pathologies
Ulcerative Colitis
Cholangiocarcinoma
Secondary Biliary Cirrhosis
Treatment
Liver Transplant
Stent
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2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
Mechanism
Autoimmune Destruction of Bile Ducts
Intrahepatic
Cholestasis
Occurs in Middle-Aged Females
Signs and Symptoms
Fatigue
Pruritus
Skin Hyperpigmentation
Hepatomegaly
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3 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
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2 mins
Clonorchis Sinensis
Pathophysiology
Trematode (Fluke)
Undercooked Fish
Biliary Tract Inflammation
Pigmented Gallstones
Associated with Cholangiocarcinoma
Treatment
Praziquantel
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1 min
Cholecystitis Assessment
RUQ Pain
Referred Shoulder Pain
Clay Colored Stools
Jaundice
Nausea and Vomiting
Dyspepsia (Indigestion)
Fever
Considerations
Increased WBCs
Fatty or Spicy Foods
Ultrasound
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2 mins
Cholecystitis Causes
Gallbladder Inflammation
6 Fs
Female
Fair (Caucasian)
Fat (Obese)
Fertile (Pregnant)
Forty (Advanced Age Over 40)
Flatulence
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2 mins
Cholecystitis Interventions
Supportive Therapy
Antibiotics
Low Fat Diet
NG Tube
Analgesics
Lithotripsy
Cholecystectomy
T Tube
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2 mins
Gallstones (Part 1/2)
Characteristics
Cholelithiasis
Pathophysiology
Increased Bilirubin
Increased Cholesterol
Stasis
Decreased Bile Salts
Cholesterol Gallstones
Cholesterol Stones are the Most Common Type
Fat, Female, Fertile, Forty, Fair Complexion
Crohn's Disease
Rapid Weight Loss
Estrogen Therapy
Native American
Diagnosis
Ultrasound
Treatment
Cholecystectomy
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3 mins
Gallstones (Part 2/2)
Cholesterol Stones
Cholesterol Stones are the Most Common Type
Radiolucent
Pigmented Stones
Black Pigment Stones
Hemolysis
Brown Pigment Stones
Infection
Radiopaque
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2 mins
Porcelain Gallbladder
Characteristics
Associated with Chronic Cholecystitis or Cholelithiasis
Increased Risk of Gallbladder Adenocarcinoma
Presentation
RUQ Pain
Usually Asymptomatic
Often Found Incidentally
Workup/Management
Confirm with CT or Ultrasound
Prophylactic Cholecystectomy
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3 mins
Acute Cholangitis Characteristics and Clinical Features
Characteristics
Biliary Tract Infection
Biliary Tract Obstruction
Clinical Features
Charcot's Triad
Fever
Jaundice
Abdominal Pain
Reynold's Pentad
+ Hypotension
+ Altered Mental Status
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2 mins
Ascending Cholangitis Diagnosis and Treatment
Imaging
ERCP
CT Scan
Ultrasound
Biliary Duct Dilation and/or Stones
Labs
Hyperbilirubinemia
Elevated Alkaline Phosphatase
Elevated GGT
Treatment
Broad Spectrum Antibiotics
Biliary Drainage
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4 mins
Bile
Synthesis and Circulation
Synthesized Continuously By Hepatocytes
Cholesterol 7 Alpha-Hydroxylase Rate Limiting Step
Stored In Gallbladder
Secreted Into Duodenum
Bile Salts Reabsorbed In Terminal Ileum
Returned To Liver Via Portal Circulation
Composition
Bilirubin
Bile Salts
Cholesterol And Phospholipids
Ions And Water
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4 mins
Jaundice
General
Due To Elevated Conjugated Or Unconjugated Bilirubin
Unconjugated
Hemolysis
Crigler-Najjar Or Gilbert's Syndrome
Physiologic Jaundice Of Newborn
Conjugated
Biliary Obstruction From Stone Or Mass
Cholangitis
Dubin-Johnson And Rotor Syndrome
Mixed
Cirrhosis
Hepatitis
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5 mins

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