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Flashcards in Gall Bladder Deck (16)
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1
Q

What kinds of disorders result in the gallbladder?

2 common examples?

A
  • Disorders involve inflm, infection, stones & tumors

* Cholecystitis (inflm) & cholelithiasis (stones) common

2
Q

Fx of gallbladder?

A

To store and concentrate bile

3
Q

Components of bile?

A
  • Bilirubin
  • Bile salts
  • Lecithin
  • Fatty acids
  • Water + electrolytes normally found in plasma
4
Q

What constitutes the hepatobiliary sytem?

A
  • Gallbladder
  • Left + right hepatic ducts - which come together to form the…
  • Common hepatic duct
  • Cystic duct (extends to the gallbladder)
  • Common bile duct (which if formed by the union of the common hepatic duct and the cystic duct
    –> common bile duct extends to the duodenum, right before which it joins with the main pancreatic duct
    (See p. 935 for picture)
5
Q

What sphincters does bile pass through before entering duodenum?

A

Sphincter on bile duct allows bile to enter into pacreatic duct (which becomes hepatopancreatic ampulla)
Sphincter of Oddi allows flow from hepatopancreatic ampulla into duodenum

6
Q

Cholelithiasis =

A

Gallstones

7
Q

Et of Cholelithiasis

How does the stone form?

A

1) Abn bile composition
(eg: inc in cholesterol, dec bile salts)
AND/OR
2) Bile stasis → precipitation

  • Inflm debris → nuclei for stone formation (particles collect around it)
  • E. Coli and Strep faecalis infections
  • Genetic susceptibility?
8
Q

Explain hypothesized reason for E. Coli and Strep faecalis infections and gallstones?

A

= suggested that those two experience infection from either of these are more susceptible to stone formation

suggested that when you have these infections, they tend to counter the composition of bile (mechanism unknown)

9
Q

Do all those who have gallstones experience symptoms?

A

No, many have them and they go undetected

10
Q

Types of gallstones?

A

• Cholestrol stones (80%) – d/t bile + elevated cholesterol content
• Pigment stones (20%)
* In both above circumstances, problem is change in bile composition, not stasis
• Mixed stones – inc overall solute concentration in the bile, variety of components (not d/t either just cholesterol or bilirubin, etc)

11
Q

What are the main components of pigment stones?

A

bilirubin + Ca salts

12
Q

Symptoms of gallstones?

A
  • Colic pain (intermittent, radiating) - can radiate to chest, back, often confused with MI
  • Nausea, vomiting? (pain, GI symptom)
13
Q

Dx of gallstones?

A
  • Physical exam, Hx
  • Ultrasound (US) – will show stones
  • Scans
14
Q

Tx of gallstones?

A
  • Pain meds
  • Drugs for nausea + Vom
  • Dissolving agents (eg: actigall)
  • Sx (eg: retrograde endoscopy – insert wire from GI tract and then into bile duct) in some cases
  • Tx complications
15
Q

How do dissolving agents work?

A

these drugs contain bile acid, the acid dissolves the stones

16
Q

What are possible complications of gallstones?

A

eg: cholecystitis, pancreatitis

perforation of duct or ball bladder..leading to possible chemical peritonitis