Exam 1: Gross and Histo features of Biliary Tract, Gallbladder, and Pancreatic Disorders

Question 1

95% of biliary tract disease is attributable to what?

Answer 1

cholelithiasis (gallstones)

Question 2

T or F: gallbladder is necessary for biliary fxn

Answer 2

F. Humans do not suffer from indigestion or malabsorption of fat after cholecystectomy

Question 3

Most common anomaly of the GB

Answer 3

Folded Fundus (w/ Phrygian Cap)

Question 4

Other congenital anomalies of the Biliary Tract aside from Folded Fundus

Answer 4

Duplication and Absence

Question 5

T or F: Biliary ducts are necessary for survival

Answer 5

T

Question 6

T or F: Biliary ducts are necessary for survival

Answer 6

T

Question 7

Important pre-operative preparation for GB

Answer 7

Radiologic dye study to know locations of ducts and presence of all probable accessory ducts

Question 8

Important pre-operative preparation for GB

Answer 8

Radiologic dye study to know locations of ducts and presence of all probable accessory ducts

Question 9

2 main types of cholelithisais

Answer 9

Pigment

Cholesterol

Question 10

In the Philippines, the most common cause of cholesterol nucleation is

Answer 10

Parasitic invasion

Question 11

Rich people stones

Answer 11

Cholesterol

Question 12

poor people stones

Answer 12

Pigment

Question 13

poor people stones

Answer 13

Pigment

Question 14

Cholesterol stones contain >50% crystalline ____________

Answer 14

Cholesterol monohydrate

Question 15

Exclusive origins of cholesterol stones

Answer 15

GB and BD

Question 16

Predominant composition of Pigment Stones

Answer 16

Bilirubin Ca Salts

Question 17

Pigment Stones arises primarily in the setting of _________ and ___________

Answer 17

Bacterial infections and parasitic infestations

Question 18

What color are the pigment stones found in sterile GB bile?

Answer 18

Black

Question 19

Where are brown pigment stones found?

Answer 19

Intra and Extrahepatic INFECTED ducts

Question 20

Where are brown pigment stones found?

Answer 20

Intra and Extrahepatic INFECTED ducts

Question 21

Unconjugated bilirubin is normally a minor component of bile but it increases when infection of the biliary tract leads to the release of __________

Answer 21

B-glucuronidases

Question 22

Risk factors for gallstones

Answer 22

fat, female, forty, and fertile

Question 23

T or F: rapid weight loss is always good for GB

Answer 23

F. FFA increase and become cholesterol along the way –> sudden push into cholesterol formation

Question 24

Greatest demographic of pigment stones

Answer 24

Asians

Question 25

Example of an ileal disease

Answer 25

Crohn's Disease (causes bypass; a risk factor for cholelithiasis

Question 26

How many percent are asymptomatic for gallstones in their lives?

Answer 26

70-80%

Question 27

Which is more dangerous? Big stones or small stones?

Answer 27

Small. Because these can enter canaliculi

Question 28

If the patient has cholesterol stones, how is this managed?

Answer 28

Diet and lifestyle

Question 29

3 things you need to make a pretty stne

Answer 29

Lecithin + Bile Salts + Cholesterol

Question 30

3 things you need to make a pretty stne

Answer 30

Lecithin + Bile Salts + Cholesterol

Question 31

Acute acalculous (cholecystitis w/o lithiasis) type chronic active cholecystitis results from

Answer 31

Weakening of the mucosal layer of the GB resulting to ischemia (immunocompromised)

Question 32

Outpuchings of mucosa in chronic inflammation

Answer 32

Rokitansky-Aschoff sinuses

Question 33

Acute acalculous (cholecystitis w/o lithiasis) type chronic active cholecystitis results from

Answer 33

Weakening of the mucosal layer of the GB resulting to ischemia (immunocompromised); predisposes to bacterial invasion

Question 34

Outpuchings of mucosa in chronic inflammation

Answer 34

Rokitansky-Aschoff sinuses

Question 35

Most common reason for emergency cholecystectomy

Answer 35

Acute cholecystitis

Question 36

Where is incidence of gangrene and perforation higher? In calculous or acalculous cholecystitis?

Answer 36

Acalculous

Question 37

Strawberry GB

Answer 37

Cholesterolosis

Question 38

Difference between deposition of cholesterol in cholesterolosis and cholelithisais

Answer 38

- losis: subsurface | - lithiasis: intima

Question 39

3 classifications of adenoma

Answer 39

tubular, papillary, tubulo-papillary

Question 40

when is adenoma diagnosed?

Answer 40

after surgery

Question 41

Where is the opening near in a choledococoele

Answer 41

near the opening of the bile duct

Question 42

A congenital dilation of the duct wherein there is a stagnation of bile predisposed to inflammation and irritation

Answer 42

Caroli's Disease

Question 43

A congenital dilation of the duct wherein there is a stagnation of bile predisposed to inflammation and irritation

Answer 43

Caroli's Disease (rosary-like dilations)

Question 44

Main endocrine fxn of the pancreas

Answer 44

insulin production

Question 45

Main exocrine fxn of the pancreas

Answer 45

Digestion enzymes (w/o it = diarrhea)

Question 46

Congenital pancreatic anomaly that predisposes to obstruction of certain anatomic structures resulting to poor drainage

Answer 46

Annular pancreas

Question 47

What can annular pancreas obstruct?

Answer 47

Ureters

Question 48

What can annular pancreas obstruct?

Answer 48

Ureters

Question 49

Most common clinically-significant congenital anomaly of teh pancreas

Answer 49

Pancreas divisum

Question 50

How many pancreas are in pancreas divisum?

Answer 50

One, looks like two due to failure of fusion

Question 51

Horror of horrors among surgeons

Answer 51

Duct aberrances (each and every duct has to be isolated and closed manually to prevent leakage and re-surgery)

Question 52

T or F: Radioimaging is safe for duct aberrances

Answer 52

F. May cause pancreatitis

Question 53

Other name of aberrant pancreas

Answer 53

choristoma

Question 54

The only manifestation of aberrant pancreas

Answer 54

noticeable bulge in the abdomen

Question 55

Pancreatic enzymes

Answer 55

1) Protease (for digestion of proteins) 2) Lipase (for fat; cleaves FA from TGs; FFAs react with Ca2+ to do saponification = chalky precipitates, Ca2+ in serum decreases) 3) Elastase (attacks elastin which strengthens the vessel walls= hemorrhage pancreatitis)

Question 56

Most common pancreas problem

Answer 56

Pancreatitis

Question 57

Most common pancreas problem

Answer 57

Pancreatitis

Question 58

Pancreatitis etiologic agents

Answer 58

Alcohol Stones Idiopathic Others (surgeries, ischemia, etc.)