Gall Bladder and Pancreas

Question 1

most common type of gall-stones

Answer 1

cholesterol

Question 2

make up of pigmented stones

Answer 2

bilirubin calcium salts

Question 3

pathernogenesis of cholesterol genes

Answer 3

cholesterol supersaturates bile –> crystalizes out of solution + hypomobility of the gallbladder and mucus hypersecretion

Question 4

major factor causing pigmented stones in US

Answer 4

sickle cell

Question 5

ethnic group most predisopsed to cholesterol stones

Answer 5

native americans

Question 6

5 fs of gallbladder risk

Answer 6

fat, fair, forty, fertile, female

Question 7

stones that are mostly radiopaque

Answer 7

pigment

Question 8

stones that arise excusivily in the gallbaldder

Answer 8

cholesterol

Question 9

presentation of gallstones

Answer 9

RUQ pain that can be constant or sporadic

Question 10

complications of gallstones

Answer 10

empyema, perforation, fistulas, pancreatitis, intestinal obstruction

Question 11

gallbladder is enlarged and tense, bright red or blotchy, and covered by fibrinous exudate

Answer 11

acute cholecystits

Question 12

present in most acute cholecystitis

Answer 12

gallstone obstructing neck of gallbladder or cystic duct

Question 13

gallbladder lumen filled with mostly pus called

Answer 13

empyema of the gallbladder

Question 14

green-black gallbladder

Answer 14

gangernous cholecystitis

Question 15

acute inflammation of a gallbladder that contains stones is

Answer 15

acute calculous cholesystiitis

Question 16

can cause non-stone cholecystitis

Answer 16

major surgery, trauma, severe burns, sepsis

Question 17

upper abdominal pain that radiates to right shoulder with abdominal rigidity

Answer 17

acute calculous cholecystitis

Question 18

nausea, vominiting and intolerance for fatty foods

Answer 18

chronic cholecystits

Question 19

complications of cholecystitis

Answer 19

bacterial superinfection with cholangitis
perforation and abcess/peritonitis
billiary enteric fistula
aggravation of preexisting illness

Question 20

precense of stones within the billiary tree

Answer 20

choledocholithiasis

Question 21

acute inflammation of the bile ducts

Answer 21

cholangitis

Question 22

causes of cholangitis

Answer 22

choledocholithiasis
surgery involving biliary tree
tumors, stents acute pancreatis

Question 23

fever chills, abdominal pain and jaundice

Answer 23

bacterial cholangitis

Question 24

risk of supperative cholangitis

Answer 24

liver abcess formation

Question 25

prolonged obstruction of the extrahepatic biliary tree can cause

Answer 25

profound damage to the liver

Question 26

neonatal cholestatis

Answer 26

biliary atresia

Question 27

treatment of biliary atresia

Answer 27

transplant

Question 28

most common type of cancer in gallbladder

Answer 28

adenocarcinoma

Question 29

adenocarcinomas that arise from cholagiocytes lining intraheptic and extrahepatic biliary ducts

Answer 29

cholangiocarcinoma

Question 30

lots if intracelylar mucin, but no bile pogment of hyaline inclusion

Answer 30

cholangiocarcinoma

Question 31

major cause of acute pancreatitis

Answer 31

alchohol abuse or biliary disease

Question 32

basic alterations in acute pancreatitis

Answer 32

``` microvasculatr leakage causing edema necrosis of fat by lipases acute inflammatory reaction proteolytic destriction of pancreatic parencyma insistial hemmorage ```

Question 33

histological findings in acute pancreattis

Answer 33

fat necrosis and calcium salts

Question 34

severe form of acute pancreatitis

Answer 34

necrotising

Question 35

critical triggering event in acute pancreatis

Answer 35

activation of trypsin

Question 36

three patheogenesis paths of acute pancreatitis

Answer 36

1) duct obstruction 2) primary acinar cell injury 3) defective intracellular transport of proenzymes within acinar cells

Question 37

location of pain in acute pancreatitis

Answer 37

epigastric pain radiating to upper back

Question 38

dx of acute pancretitis

Answer 38

elevated amylase and lipase in plasma

Question 39

non-pain signs of acute pancreatitis

Answer 39

abdominal guarding, absence of bowel souds

Question 40

sequalae of acute pancreatitis

Answer 40

abcesses or pseudocysts

Question 41

most common cause of chronic pancreatitis

Answer 41

long-term EtOH abuse

Question 42

morphology of chronic pancreatitis

Answer 42

parenchymal fibrosis reduced number and size of acini variable dilation of pancreatic ducts

Question 43

imaging result of chronic pancreatitis

Answer 43

calicfcation

Question 44

signs of chronic pancreatitis

Answer 44

jaundice, indigestion, recurrent abdominal or back pain

Question 45

long term effects of chronic pancreatitis

Answer 45

DM, chronic malabsorption, severe chronic pain, cancer

Question 46

common anecedent of pancreatic carcinoma

Answer 46

panceratic intraepithelelal neoplasias

Question 47

most frequent ocogene in pancreatic cancer

Answer 47

KRAS

Question 48

stongest enviromental risk of pancreatic cancer

Answer 48

smoking

Question 49

most common site of pancreatic carcinoma

Answer 49

head

Question 50

most common type of pancreatic carcinoma

Answer 50

ductal adenocarcinoma

Question 51

desoplastic resonse

Answer 51

reaction to pancreatic carcinoma constiting of fibroblasts, lymphocytes, and extracelllar matrix

Question 52

site of pancreatic carcinoma that tends to be silernt

Answer 52

body and tail

Question 53

presentatin of pancreatic carcinoma

Answer 53

jaundice weight los anorexia malaise and weakness

Question 54

spotting sign of pancreatic carcinoma

Answer 54

migratory thrombophebitis

Question 55

lab test used in pancreatic carcinoma

Answer 55

CA19-9