| What is the purpose of conducting an ECG in the evaluation of abdominal pathology? | to distinguish from cardiac pain | Other intra abdominal pathology like renal stones, ovarian pathology etc • LFT–Serum bilirubin, SGOT/PT, Alkaline Phosphatase • Amylase, lipase Haemogram,RFT, electrolytes, CXR, RBS, ECG (to distinguish from cardiac pain) MRCP EVALUATION OF COMORBIDITIES Indications- jaundice, high ALP, dilated CBD (on USG), suspected CBD stones or mirizzi’s syndrome (CBD obstruction caused by extrinsic compression from an impacted stone in cystic duct or Hartmann’s pouch) • DM – fasting & post prandial blood sugar, HbA1c, sugar charting • Cardiac evaluation – ECHO and other as required • COPD patient – PFT • Coagulation profile - PT/ INR • Thyroid function test Cholecystostomy followed by laparoscopic cholecystectomy by experienced laparoscopic surgeon after 6 weeks Conservative management Acute pancreatitis Early LC – within 24-72 hours (if expertise available) OR Delayed LC – after 6 weeks by experienced lap surgeon Laparoscopic Cholecystectomy | 188 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Other intra abdominal pathology like renal stones, ovarian pathology etc • LFT–Serum bilirubin, SGOT/PT, Alkaline Phosphatase • Amylase, lipase Haemogram,RFT, electrolytes, CXR, RBS, ECG (to distinguish from cardiac pain) MRCP EVALUATION OF COMORBIDITIES Indications- jaundice, high ALP, dilated CBD (on USG), suspected CBD stones or mirizzi’s syndrome (CBD obstruction caused by extrinsic compression from an impacted stone in cystic duct or Hartmann’s pouch) • DM – fasting & post prandial blood sugar, HbA1c, sugar charting • Cardiac evaluation – ECHO and other as required • COPD patient – PFT • | 1 | page=1,block=5 | 0.700 | valid |
| What is the purpose of using USG abdomen to evaluate the liver and bile ducts? | Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 437 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 1 | page=1,block=5 | 0.700 | valid |
| What condition can cause common bile duct obstruction due to extrinsic compression from an impacted stone in the cystic duct or Hartmann’s pouch? | mirizzi’s syndrome | Other intra abdominal pathology like renal stones, ovarian pathology etc • LFT–Serum bilirubin, SGOT/PT, Alkaline Phosphatase • Amylase, lipase Haemogram,RFT, electrolytes, CXR, RBS, ECG (to distinguish from cardiac pain) MRCP EVALUATION OF COMORBIDITIES Indications- jaundice, high ALP, dilated CBD (on USG), suspected CBD stones or mirizzi’s syndrome (CBD obstruction caused by extrinsic compression from an impacted stone in cystic duct or Hartmann’s pouch) • DM – fasting & post prandial blood sugar, HbA1c, sugar charting • Cardiac evaluation – ECHO and other as required • COPD patient – PFT • Coagulation profile - PT/ INR • Thyroid function test Cholecystostomy followed by laparoscopic cholecystectomy by experienced laparoscopic surgeon after 6 weeks Conservative management Acute pancreatitis Early LC – within 24-72 hours (if expertise available) OR Delayed LC – after 6 weeks by experienced lap surgeon Laparoscopic Cholecystectomy | 334 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Other intra abdominal pathology like renal stones, ovarian pathology etc • LFT–Serum bilirubin, SGOT/PT, Alkaline Phosphatase • Amylase, lipase Haemogram,RFT, electrolytes, CXR, RBS, ECG (to distinguish from cardiac pain) MRCP EVALUATION OF COMORBIDITIES Indications- jaundice, high ALP, dilated CBD (on USG), suspected CBD stones or mirizzi’s syndrome (CBD obstruction caused by extrinsic compression from an impacted stone in cystic duct or Hartmann’s pouch) • DM – fasting & post prandial blood sugar, HbA1c, sugar charting • Cardiac evaluation – ECHO and other as required • COPD patient – PFT • |
| What does MRCP stand for? | Magnetic resonance cholangiopancreatography | Lap Cholecystecto- my (if required) Cholecystostomy Non resolving symptoms Unstable Conservative management Refer to CBD stones STW Stable Conservative management only Mild/ moderate pancreatitis Lap cholecystectomy within same hospital admission Severe pancreatitis MRCP: Magnetic resonance cholangiopancreatography CBD: Common biles ducts GSD: Gall stone disease HPE: Histopathological examination LC: Laparoscopic cholecystectomy Lap cholecystectomy after 4-6 weeks of resolution of pancreatitis Acalculous cholecystitis Concomitant GSD+ CBD stones Lap cholecystectomy if symptoms persists after resolution of acute phase | 273 | definition | 0.900 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Lap Cholecystecto- my (if required) Cholecystostomy Non resolving symptoms Unstable Conservative management Refer to CBD stones STW Stable Conservative management only Mild/ moderate pancreatitis Lap cholecystectomy within same hospital admission Severe pancreatitis MRCP: Magnetic resonance cholangiopancreatography CBD: Common biles ducts GSD: Gall stone disease HPE: Histopathological examination LC: Laparoscopic cholecystectomy Lap cholecystectomy after 4-6 weeks of resolution of pancreatitis Acalculous cholecystitis Concomitant GSD+ CBD stones Lap cholecystectomy if symptoms persists after |
| What is the purpose of using USG abdomen in the investigation of gallbladder conditions? | 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 354 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 1 | page=1,block=5 | 0.700 | valid |
| What is one of the complications that can arise from acute cholecystitis? | Gangrene/ perforation | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 216 | list | 0.740 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. | 1 | page=1,block=5 | 0.700 | valid |
| What is the investigation of choice for evaluating acute cholecystitis? | USG abdomen | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 300 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. | 1 | page=1,block=5 | 0.700 | valid |
| What is the primary investigation used to assess the status of the gallbladder and detect characteristic distal acoustic shadow? | USG abdomen | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 300 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. | 1 | page=1,block=5 | 0.700 | valid |
| What is the sensitivity of USG abdomen as an investigation? | 95% | ASYPMTOMATIC COMPLICATED SYPMTOMATIC 1. Acute cholecystitis 2. Empyema 3. Mucocoele 4. Acalculous cholecystitis (critically ill patients – unexplained fever, lack of right upper quadrant tenderness, leukocytosis) 5. Gangrene/ perforation 6. Biliary obstruction 7. Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. To look for status of gall bladder and characteristic distal acoustic shadow 2. Status of liver/ CBD/ Intra hepatic biliary radicle dilatation (IHBRD) 3. | 349 | factual | 0.370 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567742_gall_stone_disease.pdf | Acute pancreatitis INVESTIGATIONS • USG abdomen–investigation of choice (sensitivity–95%) 1. | 1 | page=1,block=5 | 0.700 | valid |