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WorksheetsSurgical Jaundice
Total questions: 18
Worksheet time: 10mins
Which of the following is a pre-hepatic cause for jaundice?
Primary Biliary Sclerosis
Sickle cell anaemia
Cholelithiasis
Haemochromatosis
Which of the following blood tests would be unexpected for patient admitted with post-hepatic jaundice secondary to gallstone disease?
INR = 1.7
Alk Phos = 789
Hb = 151
Na+ = 160
What type of jaundice is seen classically with the following bloods: Hb 153, Plts 75, WCC 6.4, ALT 110, Alk Phos 132, Bili 50, PT 24
Pre-hepatic
Hepatocellular
Post-hepatic
Mixed
Which of the following is NOT a risk factor for developing gallstones?
Chemotherapy
Oral contraceptive
Haemolytic anaemia
Previous ileal resection
A 35 year old female is 4 weeks post-partum and presents with a 3 day history of progressively worsening right upper quadrant pain that radiates to her shoulder, and is worse after eating particularly fatty food. She occasionally has nausea and vomiting after meals. She denies any fevers or malaise. She notes that she had gallstones incidentally found on an ultrasound in the past, but they have never bothered her before. What has likely changed to make her asymptomatic gallstones now symptomatic?
Gallstones are seeded with intestinal bacteria
Gallstones have likely increased in size and number
Gallstones have migrated into the common hepatic duct
Gallstones are now obstructing the cystic duct causing gallbladder distention
Which of the following blood test abnormalities suggests potential common bile duct obstruction?
Elevated total bilirubin
Leucocytosis
Elevated creatinine
Hypokalaemia
Which of the following is not true about cholangitis?
Common bile duct dilatation is often observed on ultrasound with cholangitis is present
Cholangitis involves infection of the biliary tract
Choledocholithiasis might cause a biliary tract obstruction resulting in cholangitis
Hepatobiliary malignancies are the most common cause of biliary tract obstruction resulting in cholangitis
In the context of cholangitis, which of the following best described “Reynolds pentad”?
Right upper quadrant pain, nausea, jaundice, hypertension, and confusion
Right upper quadrant pain, fever, jaundice, hypotension, and confusion
Right upper quadrant pain, vomiting, jaundice, hypotension, and fever
Right upper quadrant pain, vomiting, fever, altered mental status, and hypotension
What is the most common histological subtype of cholangiocarcinoma seen?
Lymphoma
Adenocarcinoma
Squamous cell carcinoma
Sarcoma
Which of the following is not a known risk factor for cholangiocarcinoma
Haemorrhoids
Liver flukes
Primary sclerosing cholangitis
Diabetes Mellitus
What is the name of this part ( pink colour ) ?
uncinate process
head
neck
body
Which of the following is the correct description of Courvoisier’s Law
In the presence of pre-hepatic jaundice, an enlarged or palpable gallbladder makes malignancy of the biliary tree or pancreas undetermined
In the presence of jaundice and an enlarged or palpable gallbladder, malignancy of the biliary tree or pancreas should be excluded as the cause is likely to be gallstones
In the presence of intra-hepatic jaundice, the gallbladder must be palpable to exclude cholangiocarcinoma
In the presence of jaundice and an enlarged or palpable gallbladder, malignancy of the biliary tree or pancreas should be strongly suspected
Which one of the following factors does not increase the risk of developing pancreatic cancer?
Smoking
Diabetes Mellitus
Female gender
Positive family history
In which of the following scenarios is the Courvoisier’s sign most likely to be positive?
A 31 year-old male with pancreatic cancer located in the head of the pancreas
A 29 year-old female with a rapidly enlarging pancreatic pseudocyst
A 51 year-old female with a gallbladder cancer
A 32 year-old female with necrotic pancreatitis
In a Whipple’s procedure, which viscera is not removed routinely as part of the operation?
Head of the pancreas
Gallbladder
Left lobe of the liver
Antrum of the stomach
The tip of the guidewire is located in ?
common bile duct
left intrahepatic duct
pancreatic duct
intra peritoneum
( false tract )
The normal diameter of common bile duct is ?
< 5 mm
< 6 mm
< 7 mm
< 8 mm
Whipple’s procedure consist all of the procedure EXCEPT ?
pancreaticojejunostomy
jejunojejunostomy
gastrojejunostomy
choledochojejunostomy
