Cholelithiasis and Cholecystitis Flashcards Preview

Gastrointestinal > Cholelithiasis and Cholecystitis > Flashcards

Flashcards in Cholelithiasis and Cholecystitis Deck (45):
1

What is the only structures that enlarges as it approaches the skin?

Gallbladder

2

What is the location of the gallbladder?

Right costal margin at the midclavicular line

3

GB concentrations are stored bile how?

Lecithin concentrates it to a supersaturated solution

4

What is the hormone that causes the gallbladder to squeeze?

CCK

5

Where is CCK made? What causes it to be secreted?

Duodenum
Fatty meals

6

What is the effect of CCK in the brain?

Induce satiety
Inhibits hunger sensation

7

CCK inhibits the action of what hormone?

Ghrelin

8

What is the effect of CCK on beta-cell proliferation?

Induces it

9

What is the cause of visceral referral pattern of cholecystitis?

Right should blader d/t phrenic nerve

10

Who usually gets gallstones?

Fair
Fat
Female
Fertile

11

Do statins induce stone formation?

No

12

What drugs induce stone formation?

Bile sequestrants

13

What percent of the population has gallstones?

10%

14

What is the composition of gallstones?

Cholesterol
Bile salts
Lecithin
Cabilirubinate

15

Black gallstones indicate what? Brown?

Black = hemolytic disease
Brown = Infection

16

What causes choledocholithiasis?

GB wall contraction with obstruction of gallstone

17

Why is there only referred pain with early cholecystitis?

Not hitting peritoneum

18

What is the symptoms that aggravate cholecystitis?

Breathing in deeply
Eating

19

Fever and chills with usual RUQ pain = ?

Sepsis secondary to cholecystitis

20

What fraction of pts with stones never have symptoms?

2/3

21

What are the ssx of acute cholecystitis?

unrelenting, RUQ pain
Fever
n/v

22

What are the ssx of chronic cholecystitis?

Intermittent, often after fatty meals

23

What are the ssx of ascending cholangitis?

Exquisite RUQ pain, Peritoneal signs
Signs of sepsis

24

What are the US findings of the gallbladder with cholelithiasis?

may show free, impacted, or distal stones

25

What does it mean to be acalculus?

Cholecystitis but without a visible gallstone on US

26

What is the sonographic Murphy's sign?

Symptoms reproduce by pressure on probe

27

What are the complications of gallstones?

Gallstone ileus
Gallstone pancreatitis

28

What are the labs that are elevated with cholecystitis? (3)

Alk phos
Total bili
Lipase if pancreatitis

29

What is the next scan to order if the US is negative for gallstones?

HIDA scan

30

What is the general treatment of cholelithasis?

Pain control
NPO
IVF (LR)
abx if septic

31

When should pts with gallbladder issues be admitted?

Septic
impacted stone

32

What is a HIDA scan?

Nuclear med functional study, with injection of technetium into gallbladder, with CCK injected later to cause contraction

33

What are the three abnormal findings of a HIDA scan?

-Non-filling (obstructed)
-Non-emptying (non-functional)
-Symptoms with CCK

34

What is Ursodiol?

Drug that decreases cholesterol absorption

35

What is ESWL?

Shock waves into gallbladder to break up stones

36

What is the surgical treatment for cholecystitis?

Laparoscopic cholecystectomy

37

What is it a surgical emergency to remove a gallbladder?

Ascending cholangitis

38

What is ERCP?

Endoscopic retrograde cholangio pancreatoscopy

39

What are the emergent causes of cholecystitis?

-Infectious causes (ascending cholangitis)
-Gallstone pancreatitis
-Extremes of age

40

What is Charcot's triad of cholangitis?

Jaundice
Fever
RUQ pain

41

What type of bacteria usually causes cholangitis?

Gram negative

42

How do surgeons ensure that there are no stones after the gallbladder is removed?

Intraoperative cholangiogram

43

What are the medical treatments for cholecystitis?

Ursodiol
ESWL (shock waves)
Contact dissolution

44

The common cystic duct is a union between which two ducts?

Common hepatic
Common bile

45

What is the combination of cholesterol, bile salt, and lecithin that leads to cholesterol solution, rather than cholesterol stones?

Low cholesterol
High lecithin
High bile salts