11: Pathology of the biliary tract and pancreas Flashcards Preview

Gastrointestinal Week 6 2016/17 > 11: Pathology of the biliary tract and pancreas > Flashcards

Flashcards in 11: Pathology of the biliary tract and pancreas Deck (44)
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1

What is cholelithasis?

Gallstones

2

Where are gallstones most commonly found?

1. Gallbladder (because it's static)

2. Biliary system (less common because the bile flows)

3

How are symptomatic gallstones removed?

Cholecystectomy

4

What are the three main components of bile?

Bilirubin

Bile salts

Cholesterol

5

Where is bile stored and concentrated?

Gallbladder

6

Which signal triggers the release of bile into the duodenum?

CCK

7

Why do gallstones occur?

Imbalance of ratio between cholesterol and bile salts 

i.e too much cholesterol

cholesterol crystalises to form solid stones.

8

Who gets gallstones?

Female

Obese

Diabetics

9

What is haemolytic anaemia?

Increased breakdown of red blood cells, more Hb to metabolise

⇒ increased unconjugated bilirubin which the liver can't handle

10

Apart from excess cholesterol, what other factor associated with haemolytic anaemia causes gallstones?

Increased bilirubin

11

Name the two types of gallstone.

Cholesterol stones

Pigment (bilrubin) stones

12

What do gallstones cause in the biliary lining?

Infection

Inflammation

13

chronic cholecystitis is constant waves of inflammation

mucocoele - buildup of mucus

empyema - buildup of pus

ascending cholangitis - gallstone blocks bile duct leading to ascending cholangitis (infection)

gallstone ileus - eroding action of gallstone forms fistula between duodenum and gall bladder, then travels to terminal ileum and blocks ileocaecal valve

pancreatitis - gallstone blocks sphincter of oddi, pancreatitis, autodigestion of pancreas by its own enzymes

14

What is cholecystitis?

What is it usually associated with?

Inflammation of the gallbladder

Gallstones, usually

15

What causes acute cholecystitis?

Gallstones blocking outflow of bile

16

In acute cholecystitis, the gallbladder is initally sterile but soon becomes ___.

infected

17

What are some complications of acute cholecystitis?

Empyema

Rupture

Peritonitis

18

If gallstones remain after a bout of acute cholecystitis, what can occur?

Chronic cholecystitis

19

What happens to the muscle coat of the gallbladder in chronic cholecystitis?

Thickened

20

What type of cancer rarely occurs in the gallbladder?

Adenocarcinomas

21

Adenocarcinoma of the gallbladder is associated with ___.

Where can it directly spread?

gallstones

Liver

22

What is cancer of the bile ducts called?

Cholangiocarcinoma

23

What diseases are associated with cholangiocarcinoma?

Primary sclerosing cholangitis

(which itself is associated with UC)

24

What are cholangiocarcinomas also called?

Klatskin tumours

25

The pancreas is intimately associated with other organs.

Name these associations according to each part of the pancreas.

Head - duodenum, stomach, liver

Neck - bile ducts, stomach, IVC and abdominal aorta

Body - stomach, splenic artery/vein

Tail - spleen, left adrenal gland

26

In terms of the GI tract, the pancreas is heavily involved in ___ of food.

digestion

27

In terms of the endocrine system, removing the pancreas will render a patient ___.

diabetic

28

What is pancreatitis?

Inflammation of the pancreas

29

What is the main symptom of acute pancreatitis?

Sudden onset severe abdominal pain

30

Patients with acute pancreatitis is associated with elevated serum ___.

amylase