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KaBoom > Biliary System - Part 6 > Flashcards

Biliary System - Part 6 Flashcards

1
Q

What is the 5th most common malignancy?

A

GB carcinoma

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2
Q

What are the risk factors for GB carcinoma? (5)

A
  1. Cholelithiasis
  2. Porcelain GB
  3. Cholecystitis
  4. Female prevalence
  5. Greater than 60 years of age
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3
Q

What are the clinical findings for GB carcinoma? (8)

A
  1. Asymptomatic
  2. RUQ pain
  3. Palpable mass
  4. Jaundice
  5. Anorexia
  6. Nausea/vomiting
  7. Elevated alkaline
    phosphatase
  8. Mild increase in AST and ALT levels
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4
Q

What is the US appearance for GB carcinoma? (6)

A
  1. Thick, irregular GB wall
  2. Irregular intraluminal mass
  3. Immobile mass
  4. Cholelithiasis
    - 90% of cases
  5. Lymphadenopathy
  6. Metastatic liver lesions
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5
Q

What are 5 differential diagnosis for GB carcinoma?

A
  1. Adenoma
  2. Sludge
  3. Cholecystitis
  4. Adenomyomatosis
  5. Metastases
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6
Q

Is GB carcinoma more common in male or females?

A

Females

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7
Q

What are the direct extensions of metastatic GB disease? (3)

A
  1. Pancreas
  2. Stomach
  3. Bile duct
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8
Q

What are the indirect extensions of metastatic GB disease? (4)

A
  1. Melanoma
    - most common
  2. Lung
  3. Kidney
  4. Esophagus
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9
Q

What are the clinical findings for metastatic GB disease? (5)

A
  1. Asymptomatic
  2. RUQ pain
  3. Jaundice
  4. Nausea/vomiting
  5. Elevated alkaline
    phosphatase
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10
Q

What is the US appearance for metastatic GB disease? (3)

A
  1. Focal GB wall thickening
  2. Irregular intraluminal mass
  3. Non-shadowing
  4. Absence of gallstones
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11
Q

What are 3 differetial diagnosis for metastatic GB disease?

A
  1. Cholecystitis
  2. Adenoma
  3. Primary carcinoma
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12
Q

What are the complications of acute cholecystitis? (5)

A
  1. Ascending cholangitis
  2. Empyema
  3. Perforation
  4. Pericholecystic
    or liver abscess
  5. Septicemia
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13
Q

What are the causes of acute cholecystitis? (3)

A
  1. Obstruction of the cystic duct
  2. Infection
  3. Idiopathic
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14
Q

What are the risk factors of acute cholecystitis? (3)

A
  1. Female prevalence
  2. Cholelithiasis
  3. 40-50 years of age
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15
Q

Is acute cholecystitis more common in male or females?

A

Females

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16
Q

What are the clinical findings of acute cholecystitis? (7)

A
  1. Severe epigastric or RUQ pain
  2. Biliary colic
  3. Positive Murphy sign 4. Nausea/vomiting
  4. Fever and chills
  5. Elevated AST, bilirubin, and alkaline phosphatase
  6. Leukocytosis
17
Q

What is the US appearance of acute cholecystitis? (7)

A
  1. Thick, edematous GB wall
    - “halo sign”
  2. Impacted stone in the cystic duct or GB neck
  3. Cholelithiasis
    - 90% of cases
  4. Pericholecystic fluid
  5. Positive Murphy sign
  6. Peripheral hyperemia on colour
    Doppler
  7. Sludge
18
Q

What are 3 differential diagnosis for acute cholecystitis?

A
  1. Liver abscess
  2. Ascites
  3. Non-fasting patient
19
Q

What are causes of emphysematous cholecystitis? (2)

A
  1. Cholelithiasis

2. Idiopathic

20
Q

What are the clinical findings of emphysematous cholecystitis? (4)

A
  1. RUQ pain
  2. Nausea/vomiting
  3. Fever
  4. Leukocytosis
21
Q

What is the US appearance of emphysematous cholecystitis? (4)

A
  1. Echogenic focus(i) within the GB wall or lumen
  2. Ill-defined posterior acoustic shadowing
  3. Cholelithiasis
  4. Pericholecystic fluid
22
Q

What are 4 differential diagnosis of emphysematous cholecystitis?

A
  1. Acute cholecystitis
  2. Porcelain GB
  3. Large gallstone
  4. Intestinal air
23
Q

What are the risk factors for gangrenous cholecystitis? (3)

A
  1. Diabetes
  2. Older adult
  3. Male prevalence
24
Q

What are the clinical findings for gangrenous cholecystitis? (5)

A
  1. RUQ pain radiating to the back
  2. Positive Murphy sign
  3. Fever
  4. Leukocytosis
  5. Elevated AST, bilirubin, and
    alkaline phosphatase
25
What is the US appearance for gangrenous cholecystitis? (4)
1. Diffuse echogenic focus within the lumen 2. Immobile 3. Non-shadowing 4. Non-layering
26
What are 4 differential diagnosis for gangrenous cholecystitis?
1. Acute cholecystitis 2. Emphysematous cholecystitis 3. Adenoma 4. Carcinoma
27
Is gangrenous cholecystitis more common in males or females?
Males
28
What are the risk factors for GB perforation? (5)
1. Diabetes 2. Older adult 3. Infection 4. Cholelithiasis 5. Trauma
29
What are the clinical findings for GB perforation? (5)
1. RUQ mass 2. Severe RUQ or epigastric pain 3. Positive Murphy sign 4. Nausea/vomiting 5. Leukocytosis
30
What is the US appearance for GB perforation? (3)
1. Edematous, thick GB wall | 2. Pericholecystic fluid 3. Cholelithiasis
31
What is the 3 differential diagnosis for GB perforation?
1. Ascites 2. Hepatic abscess 3. Perforated peptic ulcer

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