29 extractive question-and-answer pairs built from Image guided management of Obstructive Jaundice, published by icmr.gov.in. Every answer is a verbatim span of text the source prints, and each row carries the passage it sits in, its offset in that passage, the source quote, the page and the location in the document, so any row can be checked against the original. 23 of the 29 pairs (79.3%) are explanatory questions and 6 restate a figure. 100.00% of rows pass the corpus quality gate.
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df = desidata.load("image-guided-management-of-obstructive-jaundice-question-and-answer-dataset")
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Usable for analysis, but expect some cleaning before you rely on it.
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First 10 of 29 rows
| question | answer | context | answer_start | question_type | knowledge_quality_score | source_quote | source_page | source_location | confidence | validation_status |
|---|---|---|---|---|---|---|---|---|---|---|
| What is the purpose of MRCP in the management of obstructive jaundice? | Ascertain level and cause of obstruction in the biliary tree | Ultrasound image showing causes and findings in of obstructive jaundice MEDICAL MANAGEMENT FOLLOWED BY • USG/MRCP • Lower CBD obstruction: ERCP • Higher common bile duct/Hilar Obstruction PTBD# MRCP • Ascertain level and cause of obstruction in the biliary tree • Lower CBD obstruction: ERCP preferred • High CBD obstruction: PTBD# preferred USG • CBD/IHBR dilatation • GB stone/Mass | 201 | definition | 1.000 | Ultrasound image showing causes and findings in of obstructive jaundice MEDICAL MANAGEMENT FOLLOWED BY • USG/MRCP • Lower CBD obstruction: ERCP • Higher common bile duct/Hilar Obstruction PTBD# MRCP • Ascertain level and cause of obstruction in the biliary tree • Lower CBD obstruction: ERCP preferred • High CBD obstruction: PTBD# preferred USG • CBD/IHBR dilatation • GB stone/Mass | 1 | page=1,block=67 | 0.700 | valid |
| What is the purpose of using a wire after needle placement in bile duct obstruction? | to cross stricture and place catheter/ stent percutaneously | • Raised serum bilirubin with • Markedly raised ALP and/ or GGT • Normal/ mildly raised AST/ALT GB/CBD stone causing biliary dilatation Periampullary mass causing biliary dilatation(obstruction) GB mass/cholangiocarcinoma causing biliary radicle dilatation (obstruction) Percutane- ously dilated bile duct is accessed with needle Obstruction After needle placement wire is used to cross stricture and place catheter/ stent percutaneously Patients with obstructive jaundice having no/ minimal IHBRD with distended GB may be considered for percutaneous cholecystostomy in emergent situations. | 378 | definition | 1.000 | • Raised serum bilirubin with • Markedly raised ALP and/ or GGT • Normal/ mildly raised AST/ALT GB/CBD stone causing biliary dilatation Periampullary mass causing biliary dilatation(obstruction) GB mass/cholangiocarcinoma causing biliary radicle dilatation (obstruction) Percutane- ously dilated bile duct is accessed with needle Obstruction After needle placement wire is used to cross stricture and place catheter/ stent percutaneously Patients with obstructive jaundice having no/ minimal IHBRD with distended GB may be considered for percutaneous cholecystostomy in emergent situations. | ||||
| What might cause variations in the management of an individual patient? | his/her specific condition, as decided by the treating physician | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. CLINICAL PRESENTATION • Jaundice • Pruritus • Dark coloured urine & Pale stool | 325 | relationship | 0.970 | There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. | 1 | page=1,block=64 | 0.700 | valid |
| What is recommended for patients with obstructive jaundice, a distended gall bladder, and minimal intrahepatic biliary radicle dilatation in emergency situations? | percutaneous cholecystostomy in emergent situations | • Raised serum bilirubin with • Markedly raised ALP and/ or GGT • Normal/ mildly raised AST/ALT GB/CBD stone causing biliary dilatation Periampullary mass causing biliary dilatation(obstruction) GB mass/cholangiocarcinoma causing biliary radicle dilatation (obstruction) Percutane- ously dilated bile duct is accessed with needle Obstruction After needle placement wire is used to cross stricture and place catheter/ stent percutaneously Patients with obstructive jaundice having no/ minimal IHBRD with distended GB may be considered for percutaneous cholecystostomy in emergent situations. | 538 | summary | 0.970 | • Raised serum bilirubin with • Markedly raised ALP and/ or GGT • Normal/ mildly raised AST/ALT GB/CBD stone causing biliary dilatation Periampullary mass causing biliary dilatation(obstruction) GB mass/cholangiocarcinoma causing biliary radicle dilatation (obstruction) Percutane- ously dilated bile duct is accessed with needle Obstruction After needle placement wire is used to cross stricture and place catheter/ stent percutaneously Patients with obstructive jaundice having no/ minimal IHBRD with distended GB may be considered for percutaneous cholecystostomy in emergent situations. | ||||
| What is the next step once bilirubin starts reducing in a patient? | taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | Imaging – MRCP to confirm diagnosis & look for level of obstruction, CECT abdomen to decide for definitive vs palliative care • Suspected cholangitis – Fluid resuscitation & I/V antibiotics • Biliary drainage (PTBD/ERCP) to make patient fit for surgery/palliative care (chemotherapy/radiotherapy) • PTBD preferred for high CBD/hilar obstruction, ERCP preferred in low CBD obstruction Once the bilirubin starts reducing, the patient can be: taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | 440 | summary | 0.970 | Imaging – MRCP to confirm diagnosis & look for level of obstruction, CECT abdomen to decide for definitive vs palliative care • Suspected cholangitis – Fluid resuscitation & I/V antibiotics • Biliary drainage (PTBD/ERCP) to make patient fit for surgery/palliative care (chemotherapy/radiotherapy) • PTBD preferred for high CBD/hilar obstruction, ERCP preferred in low CBD obstruction Once the bilirubin starts reducing, the patient can be: taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | 1 | page=1,block=31 | ||
| What are the follow-up steps in case of non-reducing bilirubin or signs of cholangitis? | Follow-up with IR in case of non-reducing or rise in bilirubin/sign of cholangitis/ stent block | FOLLOW UP • Follow-up with IR in case of non-reducing or rise in bilirubin/sign of cholangitis/ stent block • Patients to follow with respective physician (surgeon/medical or radiation oncologist) after successful biliary drainage and normalization of bilirubin | 12 | summary | 0.970 | FOLLOW UP • Follow-up with IR in case of non-reducing or rise in bilirubin/sign of cholangitis/ stent block • Patients to follow with respective physician (surgeon/medical or radiation oncologist) after successful biliary drainage and normalization of bilirubin | 1 | page=1,block=41 | 0.700 | valid |
| What happens once bilirubin starts reducing in a patient? | the patient can be: taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | Imaging – MRCP to confirm diagnosis & look for level of obstruction, CECT abdomen to decide for definitive vs palliative care • Suspected cholangitis – Fluid resuscitation & I/V antibiotics • Biliary drainage (PTBD/ERCP) to make patient fit for surgery/palliative care (chemotherapy/radiotherapy) • PTBD preferred for high CBD/hilar obstruction, ERCP preferred in low CBD obstruction Once the bilirubin starts reducing, the patient can be: taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | 420 | summary | 0.970 | Imaging – MRCP to confirm diagnosis & look for level of obstruction, CECT abdomen to decide for definitive vs palliative care • Suspected cholangitis – Fluid resuscitation & I/V antibiotics • Biliary drainage (PTBD/ERCP) to make patient fit for surgery/palliative care (chemotherapy/radiotherapy) • PTBD preferred for high CBD/hilar obstruction, ERCP preferred in low CBD obstruction Once the bilirubin starts reducing, the patient can be: taken up for surgery or chemo/radiotherapy or refer back to regional cancer centre | 1 | page=1,block=31 | ||
| What is the role of cholecystostomy in patients with pyocele or mucocele of the gall bladder? | may be a bridge to surgery | cholecystostomy may be a bridge to surgery in patients with pyocele/mucocele of GB CECT ABDOMEN • Identify the malignancy and extent of disease • Decide for definitive vs palliative care Biliary tract malignancy July/ 2024 RED FLAGS • Cholangitis • Pain in right hypochondrium • Fever • Chills • Tachycardia & tachypnoea • Patients should be administered IV fluids & antibiotics- Cefoperazone + Sulbactam in a ratio of 1:1 administered IV 20-40 mg/kg/day in equal doses over duration of 6-12 hrs ALP: Alkaline Transferase ALT: Alanine Aminotransferase AST: Aspartate Aminotransferase CBC: Complete Blood Count (Hemogram) CBD: Common Bile Duct CECT: Contrast Enhanced Computed Tomography ERCP: Endoscopic Retrograde Cholangiopancreatography GB: Gall Bladder GGT: Gamma Glutamyl Transferase IHBRD: Intrahepatic Biliary Radicle Dilatation IR: Interventional Radiology KFT: Kidney Function Test LFT: Liver Function Test MRCP: Magnetic Resonance Cholangiopancreatography NASH: Non Alcoholic Steatohepatitis PT/INR: Prothrombin Time/International Normalized Ratio PTBD: Percutaneous Transhepatic Biliary Drainage SAP: Serum amyloid P USG: Ultrasonography | 16 | summary | 0.970 | cholecystostomy may be a bridge to surgery in patients with pyocele/mucocele of GB CECT ABDOMEN • Identify the malignancy and extent of disease • Decide for definitive vs palliative care Biliary tract malignancy July/ 2024 RED FLAGS • Cholangitis • Pain in right hypochondrium • Fever • Chills • Tachycardia & tachypnoea • Patients should be administered IV fluids & antibiotics- Cefoperazone + Sulbactam in a ratio of 1:1 administered IV 20-40 mg/kg/day in equal doses over duration of 6-12 hrs ALP: Alkaline Transferase ALT: Alanine Aminotransferase AST: Aspartate Aminotransferase CBC: Complete | ||||
| What condition is suggested by elevated SAP and GGT with relatively normal AST and ALT levels? | obstructive etiology | KEY TO DIAGNOSIS • In presence of jaundice • High AST/ALT + relatively normal SAP/GGT suggests hepatitis • Elevated SAP & GGT + relatively normal AST/ALT suggests obstructive etiology • USG* abdomen would mostly differentiate between obstructive and non-obstructive causes COMMON ETIOLOGIES • Non obstructive: Hepatitis related- viral hepatitis (A,B,C,E,NASH, alcohol, auto-immune cirrhosis) • Obstructive: Mechanical obstruction • Benign: stone, sludge, stricture, worm, primary sclerosing cholangitis, bilio-enteric anastomotic stricture (HJ stricture) • Malignant: Carcinoma GB, hepatocellular carcinoma cholangiocarcinoma, hepatic metastasis, pancreatic head carcinoma, extrinsic compression by lymph node/mass, pseudotumor PHC Patient with clinical features and/or red flag signs CHC/DISTRICT HOSPITAL • Clinical examination; hematological investigations – LFT, CBC, PT/INR and Imaging – USG abdomen • If cholangitis is suspected – Fluid resuscitation and IV antibiotics and refer to tertiary level care for further management TERTIARY CARE • Clinical examination, repeat hematological investigations if > 2 weeks. | 163 | definition | 0.940 | KEY TO DIAGNOSIS • In presence of jaundice • High AST/ALT + relatively normal SAP/GGT suggests hepatitis • Elevated SAP & GGT + relatively normal AST/ALT suggests obstructive etiology • USG* abdomen would mostly differentiate between obstructive and non-obstructive causes COMMON ETIOLOGIES • Non obstructive: Hepatitis related- viral hepatitis (A,B,C,E,NASH, alcohol, auto-immune cirrhosis) • Obstructive: Mechanical obstruction • Benign: stone, sludge, stricture, worm, primary sclerosing cholangitis, bilio-enteric anastomotic stricture (HJ stricture) • Malignant: Carcinoma GB, hepatocellular | ||||
| What is the purpose of the broad guidelines in the STW? | advisory | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. CLINICAL PRESENTATION • Jaundice • Pruritus • Dark coloured urine & Pale stool | 171 | definition | 0.940 | These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. | 1 | page=1,block=64 | 0.700 | valid |
Read straight from the file — download or use the API URL for the full dataset.
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