*Biliary tree and pancreas disorders 1 (Lecture 8) Flashcards Preview

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Flashcards in *Biliary tree and pancreas disorders 1 (Lecture 8) Deck (60)
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1

What is the scientific name for Gallstones?

Cholelithiasis

2

what are gallstones (cholelithiasis)?

"Hard stone-like or gravel-like material formed within the biliary system most commonly the gallbladder"

3

What is normal bile formed from? (4)

Micelles of cholesterol, phospholipid, bile salts and bilirubin

4

What is bilirubin formed from?

The breakdown of RBCs in the spleen

5

Where are bile salts formed?

In the hepatocytes

6

Where is bile formed?

In the liver

7

Where is bile stored and concentrated?

In the gallbladder

8

Where is bile released?

Into the 2nd part of the duodenum through the common bile duct and Ampulla of vater

9

What hormone stimulates the release of bile from the gallbladder into the the 2nd part of the duodenum?

Cholecystokinin (CCK)

10

What causes gallstones to form?

When there is an imbalance between the ratio of cholesterol to bile salts disrupting micelle formation

11

What are the 3 different types of gallstones that can form? - different gallstones depends on the different concentrations of constituents

Cholesterol stones
Pigement stones
Mixed stones

12

When do cholesterol stones form?

When there is an excess of cholesterol in bile

13

What are the risk factors for the formation of cholesterol bile stones? (4)

Female gender
Obesity
Diabetes
Genetics

14

What do cholesterol gallstones often look like?

Large and often solitary

15

When do pigment stones form?
What can cause this (risk factor)?

When excess bilirubin cannot be solubilised in bile salts
Excess haemolysis e.g. haemolytic anaemia

16

Appearance of cholesterol gallstones?

Small, friable, irregular

17

Other than the composition of bile, what may also contribute to the formation of gallstones?

Gallbladder pH and mucosal glycoproteins

18

What type of gallstones are most gallstones?

Mixed

19

In general, what problems do gallstones cause?

Infection and inflammation of the biliary lining

20

What conditions can gallstones cause? (10)

Acute cholecystitis
Chronic cholecystitis
Mucocoele
Empyema
Carcinoma
Ascending cholangitis
Obstructive jaundice
Gallstone ileus
Acute pancreatitis
Chronic pacnreatitis

21

What is cholecystitis?

Inflammation of the gallbladder

22

What is cholecystitis usually associated with?

Gallstones

23

What causes acute cholecystitis?

Gallstones obstructing outflow of bile (initially sterile and then becomes infected)

24

What complications can acute cholecystitis cause? (4)

Empyema
Rupture
Peritonitis
Intense adhesions form within 2-3 days

25

What leukocyte signals acute inflammation?

Neutrophils

26

What is chronic cholecystitis?

Chronic inflammation of the gallbladder

27

What causes chronic cholecystitis?

Usually associated with gallstones - may develop insidiously or after bouts of acute cholecystitis

28

What is the appearance of the gallbladder in chronic cholecystitis?

Gallbladder wall is thickened (due to fibrosis) but not distended

29

What are Rokitansky-Aschoff sinuses?

Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer and subserosal tissue as a result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall. They are usually referred to as adenomyomatosis - usually due to increased pressure and recurrent damage of the gallbladder wall

30

What is cholestasis?

A condition where bile can not flow from the liver to the duodenum