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)
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1
Q

What ethnicity gets GI disease more than any other?

A

Mexicans

2
Q

What are the 2 types of gall stones?

A
  1. Cholesterol

2. Pigmented

3
Q

Who is most likely to get gall stones?

A

Fair, Forty year old, Female

4
Q

What is cholecystokinin (CCK)?

A

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

5
Q

What is biliary colic?

A

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

6
Q

What causes biliary colic?

A

CCK stimulated gallbladder contraction

7
Q

What bacteria is the most common cause of acute cholecystitis?

A

E. coli, followed by Klebsiella

8
Q

What is the general presentation of acute cholecystitis?

A

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

9
Q

Wha tis murphy’s sign?

A

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

10
Q

What is acute acalculous cholecystitis?

A

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

11
Q

What causes acute acalculous cholecystitis?

A

gallbladder stasis and ischemia

*classically long term ICU patients

12
Q

How do you diagnose acalculous cholecystitis?

A

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

13
Q

What should you think if you see porcelain gallbladder?

A

gallbladder cancer

14
Q

What is choledocholithiasis?

A

stones in the bile ducts

15
Q

What is the biggest risk factor for cholangiocarcinoma?

A

sclerosing cholangitis

16
Q

What should you do to a patient with asymptomatic gallstones?

A

LEAVE THEM ALONE

17
Q

** 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)

A

CCK stimulated gallbladder contraction

18
Q

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

A

RUQ pain, fever, jaundice

19
Q

** 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)

A

ERCP (Endoscopic retrograde cholangiopancreatography)

20
Q

** 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).

A

LEAVE IT ALONE