Diseases of the Gallbladder and Biliary System Flashcards Preview

Pathology > Diseases of the Gallbladder and Biliary System > Flashcards

Flashcards in Diseases of the Gallbladder and Biliary System Deck (21):
1

Name the radiologic procedure of choice for diagnosing cholelithiasis.

ULTRASONOGRAPHY has a high sensitivity and specificity for gallstones and should be performed as the diagnostic study of choice when evaluating biliary colic or or cholecystitis.

2

Define "acalculous cholecystitis"

~10% of Gallbladders with all of the pathologic findings of acute cholecystitis contain no gallstones. This is referred to as ACALCULOUS Cholecystitis - associated mortality is high

3

Choledocholithiasis

Presence of stones within the biliary tree

4

Cholangitis

Acute inflammation of the walls of the bile ducts

5

Cholecystitis

Inflammation of the gallbladder

6

Cholelithiasis

Gall stones in the gallbladder lumen

7

What are the most common kind of gallstones?

Cholesterol Stones

8

What are the risk factors for cholesterol gall stones?

Female
Fat
Forty
Fertile
Flatulant

9

What is is the most comon manifestation of symptomatic gallstones?

Biliary Colic - pain lasts less than 3 hours

10

Where does biliary colic pain radiate?

To the right shoulder or scapula

11

Acute Cholecystitis

Symptoms characterized by acute onset of right upper quadrant pain, fever and leukocytosis.

As in biliary colic, pain may radiate to right shoulder.

12

Murphy Sign

It is an arrest in inspiration during direct palpation of the right upper quadrant

13

Acute cholecystitis develops because a gallstone (or gallstones) usually obstructs what?

Cystic Duct

14

What characterizes the type of gallstone that is more likely to cause acute cholecystsis?

Small gravel like stone

15

What are potential complications of acute cholecystitis?

Bacterial superinfection

Sepsis

Perforation of gallbladder

Cholecystoenteric fistula (fistula formatoin between gallbladder and the intestine

16

HIDA Scan

HIDA scan uses technetium labeled hepatic iminodiacetic acid (HIDA) tracer which is injeced intravenously and is then taken up by hepatocytes and excreted in bile. If the cystic duct is patent, the tracer will enter the gallbladder leading to its visualization.

17

Porcelain Gallbladder

Long standing chronic inflammation (ie chronic cholecystitis) may lead to extensive CALCIFICATION of the gallbladder wall.

Porcelain gallbladders are particularly prone to developing gallbladder cancer (adenocarcinoma)

18

What is the most common clinical presentation of extra-hepatic cholangiocarcinomas?

Jaundice

19

One of the most common micro-organisms cultured from bile in the setting of acute cholangitis

E. coli

20

Gallstones may serve as a persistent nidus of infection and risk for chronic carriage of this organism.

Salmonella typhi

21

Risk factor for cholangiocarcinoma, particularly in Asia (Thailand)

Clonorchis sinensis

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