Gallbladder problems

Question 1

what is cholelithiasis?

Answer 1

stones in the gallbladder, gallstones

Question 2

what is the etiology of cholelithiasis?

Answer 2

impaired metabolism of cholesterol, bilirubin, and bile acidsw

Question 3

what are the 3 types of gallbladder stones?

Answer 3

cholesterol, pigmented, and mixed

Question 4

what are the risk factors for cholelithiasis?

Answer 4

-obesity
-female
-middle aged (40s)
-oral contraceptives
-people with rapid weight loss
-indigenous american / white
- genetic
-people with pancreatic or ileal disease

Question 5

if gallstones remain in the gallbladder what are the symptoms?

Answer 5

none, typically remain asymptomatic

Question 6

what are the clinical manifestations of cholelithiasis?

Answer 6

• epigastric / RUQ pain
• intolerance to fatty foods
  -heartburn
  -flatulence
• biliary colic
  -jaundice

Question 7

with cholelithiasis why would the patient experience jaundice?

Answer 7

because bile is unable to flow into the duodenum - leaving excess bilirubin outside of the intestines

Question 8

with cholelithiasis why would the patient have dark urine that foams when shaken?

Answer 8

there is soluble bilirubin in the urine - this happens when conjugated billirubin escapes into the bloodstream and gets through the kidney filtration into the urine

Question 9

with cholelithiasis why would the patient experience clay colored stools?

Answer 9

bilirubin is unable to reach the small intestines to be converted to urobilinogen (which is responsible for the brown color of feces)

Question 10

with cholelithiasis why would the patient experience steatorrhea?

Answer 10

bile salts are unable to get into the duodenum which prevents fat digestion

Question 11

with cholelithiasis why would the patient experience pruritus?

Answer 11

there has been a deposit of bile salts into skin tissue - bile salts build up and irritate the peripheral nervous system causing itching

Question 12

with cholelithiasis why would the patient experience intolerance to fatty foods?

Answer 12

bile is unable to reach the small intestines to help with fat digestion

Question 13

with cholelithiasis why would the patient experience bleeding tendencies?

Answer 13

there is decreased absorption of vitamin K due to lack of bile in the small intestines

Question 14

what is cholecystitis?

Answer 14

acute or chronic inflammation of the gallbladder

Question 15

in the case of cholecystitis where is the common obstruction?

Answer 15

a gallstone lodged in the cystic duct for a long time

Question 16

what does cholecystitis lead to?

Answer 16

a distended and inflamed gallbladder

Question 17

in the case of cholecystitis there is pressure against a distended wall of the gallbladder leads to decreased blood flow which can lead to what 3 things?

Answer 17

ischemia, necrosis, and perforation

Question 18

what are common clinical manifestations with cholecystitis?

Answer 18

fever, leukocytosis, rebound tenderness, and guarding

Question 19

what lab values are commonly elevated with cholecystitis?

Answer 19

bilirubin and alk phos