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Biliary Gallbladder Flashcards

(66 cards)

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1
Q

Cholelithiasis

A

Gallstones

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2
Q

2 types of gallstones?

A
  1. Cholesterol

2. Pigment stones (calcium)

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3
Q

Symptoms of Cholelithiasis?

A
  • Starts as Asymptomatic
  • Stones trigger inflammation or cause obstruction*
    = Biliary Colic, Right scapula/back pain and N/V
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4
Q

What is Biliary Colic?

A

RUQ steady ache especially 30-90 minutes after meals

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5
Q

Symptoms of Cholelithiasis?

A
  • Starts as Asymptomatic
  • Stones trigger inflammation or cause obstruction*
    = Biliary colic, Right scapula/back pain and N/V
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6
Q

With Cholelithiasis the laboratory findings are normal. What test should you do and what will it show?

A

RUQ US

= Stones with acoustic shadowing

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7
Q

Risk factors for Cholelithiasis?

A

Female, Fertile, Fat, 40, Fair, Family history

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8
Q

Protective factors against Cholelithiasis?

A

Low carbs, High fiber
Physical activity
Coffee and NSAIDs and Statin therapy

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9
Q

Cholecystitis

A

Gallbladder inflammation

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10
Q

2 common causes of Acute Cholecystitis?

A
  1. Calculous (stones) in cystic duct

2. Acalculous (no stones) = illness/infections

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11
Q

Symptoms of Acute Cholecystitis?

A

Fatty meal causes attack:

= Pain in RUQ/epigastrum, fever, N/V

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12
Q

Symptoms of Acute Cholecystitis?

A

Fatty meal causes attack:

= Pain in RUQ/epigastrum, fever, N/V

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13
Q

What are the (+) signs of Acute Cholecystitis?

A

(+) murphy sign

(+) dark colored urine and acholic stools

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14
Q

Tea colored dark urine and acholic stools are seen with?

A

Acute Cholecystitis

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15
Q

What will the RUQ US show with Acute Cholecysitits?

A

GB wall thickening, pericholecystic fluid, stones and acoustic shadow

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16
Q

What will the RUQ US show with Acute Cholecystitis?

A

GB wall thickening, pericholecystic fluid, stones and acoustic shadow

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17
Q

Treatment for Acute Cholecystitis?

A

Surgery and antibiotics

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18
Q

2 possible complications of Acute Cholecystitis?

A
  1. GB gangrene

2. Emphysematous Cholecystitis

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19
Q

2 possible complications of Acute Cholecysitits?

A
  1. GB gangrene

2. Emphysematous Cholecystitis

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20
Q

What is the order of events if gangrene of the gallbladder occurs?

A
  • Perforation
  • Abscess
  • Peritonitis
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21
Q

What is a huge risk factor for developing emphysematous cholecystitis?

A

UNCONTROLLED diabetes mellitus

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22
Q

What is emphysematous cholecystitis and what causes it?

A

Gas in the wall of the gallbladder

– due to uncontrolled diabetes or acute cholecystitis

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23
Q

Treatment for emphysematous cholecystitis?

A

Urgent Cholecystectomy

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24
Q

What causes Chronic Cholecystitis?

A

Repeated cholecystitis due to gallstones

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25
Symptoms of Chronic Cholecystitis?
- Asymptomatic | - - Intermittent, post-prandial RUQ pain and dyspepsia
26
Symptoms of Chronic Cholecystitis?
- Asymptomatic | - - Intermittent, post-prandial RUQ pain and dyspepsia
27
What will RUQ US show with Chronic Cholecystitis?
Gallstones and contracted gallbladder
28
Contracted gallbladder is seen with?
Chronic Cholecystitis
29
Possible complication of Chronic Cholecystitis?
Porcelain GB
30
Porcelain Gallbladder
- possible complication of Chronic Cholecystitis | = Calcified Gallbladder
31
Porcelain gallbladder increases your risk for?
Gallbladder cancer
32
Choledocholithiasis
Gallstones in common bile duct
33
Symptoms of Choledocholithiasis?
Severe RUQ pain, fever, jaundice
34
Symptoms of Choledocholithiasis?
Severe RUQ pain, fever, jaundice
35
What labs will be elevated with Choledocholithiasis?
Liver enzymes and possibly lipase/amylase due to secondary pancreatitis
36
What test should be done if Choledocholithiasis is suspected?
ERCP with sphincterotomy and stone extraction/stent placement
37
What test should be done if Choledocholithiasis is suspected?
ERCP with sphincterotomy and stone extraction/stent placement
38
Possible complications of Choledocholithiasis?
Acute pancreatitis | Ascending Cholangitis
39
What may cause Ascending Cholangitis?
Choledocholithiasis
40
What is Ascending Cholangitis?
Obstruction in common bile duct causes infection of the biliary tract
41
Possible symptoms with Ascending Cholangitis?
- Charcot triad: RUQ pain, fever, jaundice | - Reynold pentad: charcot triad, hypotension, altered mental status
42
Possible symptoms with Ascending Cholangitis?
- Charcot triad: RUQ pain, fever, jaundice | - Reynold pentad: charcot triad, hypotension, altered mental status
43
With Ascending Cholangitis, what will the lab tests show?
``` Leukocytosis Blood cultures (+) ```
44
What test should be done with Ascending Cholangitis?
ERCP with sphincterotomy and stone extraction/stent placement
45
Possible complication of Ascending Cholangitis?
Acute pancreatitis
46
What is Biliary Dyskinesia?
Functional disorder of gallbladder
47
Symptoms of Biliary Dyskinesia?
Frustrated patient with biliary colic
48
With Biliary Dyskinesia, all tests come back NORMAL. What test should you do?
HIDA scan with CCK
49
With Biliary Dyskinesia, what will the HIDA scan with CCK show?
Abnormal ejection fraction (less than 35-38%)
50
Primary Sclerosing Cholangitis is often associated with?
Males with IBD -- Ulcerative colitis
51
Primary Sclerosing Cholangitis is often associated with?
Males with IBD -- Ulcerative colitis
52
Symptoms of Primary Sclerosing Cholangitis?
RUQ pain, jaundice, pruritus
53
Symptoms of Primary Sclerosing Cholangitis?
RUQ pain, jaundice, pruritus
54
What is elevated with Primary Sclerosing Cholangitis?
Alkaline Phosphatase and bilirubin
55
What will the MRCP/ERCP show with Primary Sclerosing Cholangitis?
"beads on a string" | = segmental fibrosis of bile ducts with dilations between them
56
"beads on a string" with ERCP?
Primary Sclerosing Cholangitis
57
What will the liver biopsy show with Primary Sclerosing Cholangitis?
Onion skinning
58
Primary Sclerosing Cholangitis puts you at increased risk for?
Increased risk for cholangiocarcinoma, colon cancer and ascending cholangitis
59
Is there proven therapy for Primary Sclerosing Cholangitis?
NO
60
What is Primary Biliary Cholangitis?
Autoimmune destruction of small intrahepatic bile ducts and cholestasis
61
What is Primary Biliary Cholangitis?
Autoimmune destruction of small intrahepatic bile ducts and cholestasis
62
What increases your risk of Primary Biliary Cholangitis?
Female, UTIs, Hormone therapy, smoking and hair dye use
63
What will the lab results show with Primary Biliary Cholangitis?
ISOLATED elevated Alkaline Phosphatase (increased GGT) Antimitochondrial antibodies
64
What will the lab results show with Primary Biliary Cholangitis?
ISOLATED elevated Alkaline Phosphatase (increased GGT) Antimitochondrial antibodies
65
Symptoms of Primary Biliary Cholangitis?
Jaundice, pruritus, xanthelasma
66
Symptoms of Primary Biliary Cholangitis?
Jaundice, Pruritus, xanthelasma

GI - 2 (61 decks)

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