Return to course: NICE CKS Question Banks
Previous Lesson
Previous
Next
Next Lesson
Cholecystitis – Acute (PG)
Return to
Course Curriculum
1. What is the most common cause of acute cholecystitis?
*
Gallstone obstruction of the cystic duct
Viral infection
Alcohol use
Pancreatic tumour
2. Which symptom is most typical in acute cholecystitis?
*
Epigastric burning relieved by food
Sudden severe LUQ pain
RUQ pain with fever
Diffuse abdominal distension
3. What is Murphy’s sign?
*
Rebound tenderness in RLQ
Pain on deep inspiration with RUQ palpation
Pain radiating to back
Hypoactive bowel sounds
4. Which investigation is first-line for suspected acute cholecystitis?
*
CT abdomen
Abdominal ultrasound
MRCP
ERCP
5. Which lab findings support the diagnosis of acute cholecystitis?
*
Low white cells and raised amylase
Elevated CRP and WCC
Low platelets and raised bilirubin
Normal LFTs and negative cultures
6. What is the typical management of confirmed acute cholecystitis in hospital?
*
Oral antibiotics and discharge
IV fluids, antibiotics and early laparoscopic cholecystectomy
Appendectomy
Immediate ERCP
7. Which complication can result from untreated cholecystitis?
*
Colonic stricture
Splenic infarct
Gallbladder perforation
Pancreatic cancer
8. In which group is acalculous cholecystitis more common?
*
Pregnant women
African Caribbean Patients
Children
Critically ill patients
9. Which condition may mimic cholecystitis due to similar RUQ pain?
*
Appendicitis
Diverticulitis
Peptic ulcer
Hepatitis
10. What dietary advice is usually given post-cholecystectomy?
*
High fat intake
Low fibre diet
Avoiding fatty foods initially
D. Only liquids for 5 days
11. What finding on ultrasound is most specific for acute cholecystitis?
*
Dilated bile ducts
Gallstones only
Thickened gallbladder wall
Sludge in gallbladder
12. What is Charcot’s triad used to identify?
*
Chronic cholecystitis
Acute pancreatitis
Cholangitis
Peptic ulcer disease
13. Which antibiotic regimen is often used initially for acute cholecystitis?
*
Co-amoxiclav
Nitrofurantoin
Amoxicillin only
Flucloxacillin
14. Which pain feature helps differentiate cholecystitis from biliary colic?
*
Worse after fatty meals
Colicky in nature
Radiation to groin
Constant pain lasting >6 hours
15. What is the most serious complication of untreated gangrenous cholecystitis?
*
Peritonitis
GORD
Anaemia
Chronic diarrhoea
16. How soon is laparoscopic cholecystectomy ideally performed in acute cholecystitis?
*
After 2 weeks
Within 7 days of symptom onset
After 3 months
Immediately on diagnosis
17. Which of the following would contraindicate laparoscopic cholecystectomy?
*
Uncontrolled coagulopathy
Diabetes
Mild obesity
Mild jaundice
18. What finding may indicate gallbladder empyema?
*
Improvement with fluids
New confusion
Pus-filled gallbladder on scan
Increased appetite
19. What is the definitive treatment for recurrent gallstone cholecystitis?
*
Antibiotics
Diet changes
Proton pump inhibitors
Gallbladder removal
20. What is the purpose of ERCP in gallbladder disease?
*
Removing bile duct stones
Diagnosing gastritis
Imaging kidneys
Draining abscesses