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ABDOMEN REVIEW > Biliary System > Flashcards

Biliary System Flashcards

1
Q

Which ducts join to form the CHD?

A

right and left hepatic ducts

E 40

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2
Q

Which ducts join to form the CBD?

A

cystic duct and CHD

E 40

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3
Q

Which ducts join to form the ampulla of Vater?

A

CBD and Duct of WIrsung in the pancreas

E 40

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4
Q

What does the portal triad consist of?

A

MPV
CHD
proper HA
E 40

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5
Q

What do the valve of Heister’s control?

A

controls the bile flow in the cystic duct

E 41

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6
Q

What is Hartmann’s pouch?

A

abnormal sacculation of the neck of the GB

E 41

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7
Q

What is a phrygian cap?

A

fold between the body and fundus

E 41

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8
Q

What is a junctional fold?

A

fold between the body and neck

E 41

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9
Q

Where does the ampulla of Vater empty into?

A

passes through the sphincter of Oddi into the duodenum

E 41

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10
Q

What is normal GB wall thickness?

A

less than 3 mm

E 42

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11
Q

What are causes of GB wall thickening?

A 
Cholecysitis
hypoalbuminemia
ascites
hepatitis
congestive heart failure
pancreatitis
E 43
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12
Q

What is sludge associated with?

A 
biliary stasis
prolonged fasting 
hemolysis
cystic duct obstruction
cholecystitis
E 43
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13
Q

What is a gallbladder filled with stones called?

A

WES sign

E 44

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14
Q

What features are present with acute cholecystitis?

A 
gallstones
Murphy's sign
diffuse wall thickening
gallbladder dilitation 
sludge
E 45
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15
Q

What is considered chronic cholecystitis?

A

history of multiple episodes of acute cholecystitis, sonographically the same as acute cholecystitis
E 45

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16
Q

What is emphysematous cholecystitis?

A

acute cholecystitis due to wall ischemia and infection

E 46

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17
Q

What is empyema of the gallbladder?

A

pus within the gallbladder

E 47

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18
Q

What is gallbladder perforation?

A

localized fluid collection in the gb fossa

E 47

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19
Q

What is acalculous cholecystitis?

A

acute cholecystitis without gallstones

E 48

20
Q

What is a porcelain gallbladder?

A

calcification of the gallbladder wall

E 49

21
Q

What is hydrops of the gallbladder?

A

overdistended gb
asymptomatic
E 49

22
Q

What size of gallbladder polyps are considered benign?

A

< 10 mm

E 49

23
Q

What is cholesterolosis?

A

lipids deposited into the gallbladder wall appearing like polyps
E 50

24
Q

What are the sonographic findings of gallbladder carcinoma?

A

intraluminal mass
asymmetric wall thickening
mass that fills the gb
E 50

25
Q

What is adenomyomatosis?

A

hyperplastic changes involving the gallbladder wall forming a thickened wall and diverticula
E 51

26
Q

What artifact is associated with adenomyomatosis?

A

comet-tail (reverberation)

E 51

27
Q

Where in the biliary tract is biliary obstruction most common?

A

distal CBD

E 52

28
Q

What are the 2 most common reasons for biliary obstruction?

A

gallstones
carcinoma of the head of the pancreas
E 52

29
Q

Obstruction of the biliary tract would elevate which lab values?

A

alk phos
bilirubin
E 52

30
Q

What is a normal measurement of the CBD postcholecystectomy?

A

up to 10 mm

E 53

31
Q

What is it called when the dilated hepatic duct is parallel to the portal vein?

A

Shotgun sign

E 54

32
Q

What is choledocholithiasis?

A

calculi present in the bile ducts

E 56

33
Q

What are symptoms of choledocholithiasis?

A

RUQ pain
jaundice
E 56

34
Q

What is Mirizzi Syndrome?

A

extrahepatic biliary obstruction due to a stone in the cystic duct
E 56

35
Q

What is a common finding with cholangiocarcinoma?

A

intrahepatic dilatation

E 57

36
Q

What is cholangitis?

A

bacterial infection caused from obstruction of the biliary tree.

37
Q

When is biliary atresia suspected?

A

when jaundice persists beyond 14 days old

E 58

38
Q

What is pneumobilia?

A

air in the biliary tract

E 58

39
Q

What findings are seen with pneumobilia?

A

echogenic foci with comet-tail reverberation

E 59

40
Q

What is a choledochal cyst?

A

cystic dilitation of the bile ducts

E 59

41
Q

What are the sonographic findings of choledochal cysts?

A

two cystic structures in the GB and CBD

E 59

42
Q

What is Caroli’s disease?

A

congenital anomaly where there is dilitation of the intrahepatic ducts
E 60

43
Q

What are the sonographic findings in Caroli’s disease?

A

multipe cystic structures that converge towards the porta hepatis communitcating with the bile ducts
sludge and calculi can be seen
E 60

44
Q

What is courvoisier gallbladder?

A

enlarged non-diseased GB due to obstruction of the CBD

E 60

45
Q

What lab value is elevated in biliary disease?

A

conjugated bilirubin and alk phos

E 62

ABDOMEN REVIEW (7 decks)

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