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Common Cholangitis exam questions for medical finals, OSCEs and MRCP PACES

 

Question 1.

What are the common causes of cholangitis?

  • Obstruction of biliary tree secondary to gallstones  (including Mirizzi’s syndrome)
  • Infection post-ERCP
  • Roundworm or liver fluke infection (common overseas)
  • Invasion by tumour: Pancreatic, cholangiocarcinoma, hepatocellular carcinoma, metastases
  • HIV cholangiopathy

 

Question 2.

List the three signs that make up the classical Charcot triad.

  • Jaundice
  • Fever
  • RUQ pain – severe

 

Question 3.

List the signs that make up Reynold's pentad.

  • Charcot’s triad
    • Jaundice
    • Fever
    • RUQ pain – severe
  • PLUS
    • Septic shock
    • Confusion

 

Question 4.

What are the common organisms isolated from blood cultures in cholangitis?
  • E.coli (20-25%)
  • Klebsiella (10-15%)
  • Enterobacter (5-10%)