Clinical Presentation of Cholecystitis (Acalculous, Acute and Chronic) Flashcards Preview

Gastrointestinal 1 > Clinical Presentation of Cholecystitis (Acalculous, Acute and Chronic) > Flashcards

Flashcards in Clinical Presentation of Cholecystitis (Acalculous, Acute and Chronic) Deck (20):
1

What ethnicity gets GI disease more than any other?

Mexicans

2

What are the 2 types of gall stones?

1. Cholesterol
2. Pigmented

3

Who is most likely to get gall stones?

Fair, Forty year old, Female

4

What is cholecystokinin (CCK)?

major hormone (produced in discrete endocrine cells that line the mucosa of the duodenum) responsible for gallbladder contraction and pancreatic enzyme secretion.

5

What is biliary colic?

waxing and waning, poorly localized, postprandial UPPER ABDOMINAL PAIN radiating to the back with normal lab evaluations of liver function.

6

What causes biliary colic?

CCK stimulated gallbladder contraction

7

What bacteria is the most common cause of acute cholecystitis?

E. coli, followed by Klebsiella

8

What is the general presentation of acute cholecystitis?

RUQ pain, +/- fever, +murphy's sign, leukocytosis, nonspecfic elevation of liver enzymes

9

Wha tis murphy's sign?

inability to deeply to inspire when you push on the RUQ.

10

What is acute acalculous cholecystitis?

cholecystitis without stones. It carries higher morbidity and mortality than acute calculous cholecystitis (with stones).

11

What causes acute acalculous cholecystitis?

gallbladder stasis and ischemia
*classically long term ICU patients

12

How do you diagnose acalculous cholecystitis?

gallbladder not visualized on HIDA scan or there is reduced ejection fraction

13

What should you think if you see porcelain gallbladder?

gallbladder cancer

14

What is choledocholithiasis?

stones in the bile ducts

15

What is the biggest risk factor for cholangiocarcinoma?

sclerosing cholangitis

16

What should you do to a patient with asymptomatic gallstones?

LEAVE THEM ALONE

17

**** A 42 y/o obese female presents with waxing and waning RUQ pain that radiates to the back that came on 2 hours after consuming a large, fatty meal. Liver enzymes are normal. Ultrasonography demonstrates stones in the neck of the gallbladder. The postprandial pain is most likely caused by what? (TEST QUESTION)

CCK stimulated gallbladder contraction

18

**** Charcot's triad consists of which of the following? (TEST QUESTION)

RUQ pain, fever, jaundice

19

**** A 44 y/o female presents to the ER w/ RUQ pain, fever, and jaundice. Ultrasound shows gallstones, a thickened gallbladder wall, and a common bile duct size measuring 1.6 cm. There is a high probability of choledocolithiasis. Your next step to both diagnose and treat this patient would be what? (TEST QUESTION)

ERCP (Endoscopic retrograde cholangiopancreatography)

20

**** A 47 y/o female presents to the ER w/a fractured ankle. Upon full workup, studies reveal gallstones in her gallbladder. She has no GI complaints. Your next best step to treating the gallstones would be what? (TEST QUESTION).

LEAVE IT ALONE