Flashcards in Cholelithiasis and Cholecystitis Deck (45):
What is the only structures that enlarges as it approaches the skin?
What is the location of the gallbladder?
Right costal margin at the midclavicular line
GB concentrations are stored bile how?
Lecithin concentrates it to a supersaturated solution
What is the hormone that causes the gallbladder to squeeze?
Where is CCK made? What causes it to be secreted?
What is the effect of CCK in the brain?
Inhibits hunger sensation
CCK inhibits the action of what hormone?
What is the effect of CCK on beta-cell proliferation?
What is the cause of visceral referral pattern of cholecystitis?
Right should blader d/t phrenic nerve
Who usually gets gallstones?
Do statins induce stone formation?
What drugs induce stone formation?
What percent of the population has gallstones?
What is the composition of gallstones?
Black gallstones indicate what? Brown?
Black = hemolytic disease
Brown = Infection
What causes choledocholithiasis?
GB wall contraction with obstruction of gallstone
Why is there only referred pain with early cholecystitis?
Not hitting peritoneum
What is the symptoms that aggravate cholecystitis?
Breathing in deeply
Fever and chills with usual RUQ pain = ?
Sepsis secondary to cholecystitis
What fraction of pts with stones never have symptoms?
What are the ssx of acute cholecystitis?
unrelenting, RUQ pain
What are the ssx of chronic cholecystitis?
Intermittent, often after fatty meals
What are the ssx of ascending cholangitis?
Exquisite RUQ pain, Peritoneal signs
Signs of sepsis
What are the US findings of the gallbladder with cholelithiasis?
may show free, impacted, or distal stones
What does it mean to be acalculus?
Cholecystitis but without a visible gallstone on US
What is the sonographic Murphy's sign?
Symptoms reproduce by pressure on probe
What are the complications of gallstones?
What are the labs that are elevated with cholecystitis? (3)
Lipase if pancreatitis
What is the next scan to order if the US is negative for gallstones?
What is the general treatment of cholelithasis?
abx if septic
When should pts with gallbladder issues be admitted?
What is a HIDA scan?
Nuclear med functional study, with injection of technetium into gallbladder, with CCK injected later to cause contraction
What are the three abnormal findings of a HIDA scan?
-Symptoms with CCK
What is Ursodiol?
Drug that decreases cholesterol absorption
What is ESWL?
Shock waves into gallbladder to break up stones
What is the surgical treatment for cholecystitis?
What is it a surgical emergency to remove a gallbladder?
What is ERCP?
Endoscopic retrograde cholangio pancreatoscopy
What are the emergent causes of cholecystitis?
-Infectious causes (ascending cholangitis)
-Extremes of age
What is Charcot's triad of cholangitis?
What type of bacteria usually causes cholangitis?
How do surgeons ensure that there are no stones after the gallbladder is removed?
What are the medical treatments for cholecystitis?
ESWL (shock waves)
The common cystic duct is a union between which two ducts?