Gallbaldder Flashcards Preview

Old DOOS > Gallbaldder > Flashcards

Flashcards in Gallbaldder Deck (72):
1

stones present in GB

cholelithiasis

2

inflammation of GB, +/- stones (sludge)

cholecystitis

3

stone in CBD (common bile duct) causing pain, jaundice, pancreatitis
can be acute or chornic

Choledocholithiasis

4

stones or sludge in gallbladder that last for awhile
can have thickening of gallbladder wall and if it has calcium

chronic cholecystitis

5

what causes fatty food intolerance?

lack of bile salts

6

what causes episodic pain from the gallbaldder?

Intermittent obstruction

7

what causes pale feces?

lack of bile coloration

8

what causes pruritis from a gallbladder problem?

cholestasis, bile irritating skin

9

what is bile mostly made of?

Cholesterol from the liver

10

Of the 200-400 bilirubin produced each day, what happens to most of it?

fecal urobilinogen
some extreted in urine (urobilinogen)
some recycled

11

If urobilinogen is backing up in the systemic system, what might your urine look like?

Brown, like tea

12

with acute cholecystitis what will you have?

Fever
Leukocytosis
Alkaline phosphate elevate (from liver and bone) because GB is irritating liver
may have N/V (ileus possible)
pancreatitis, metabolic derangement's

13

What causes pancreatitis? from GB problem

If sludge, stone gets to distal end of bile duct and blocks the pancreatic duct.

14

Symptoms of pancreatitis

Band-like pain near umbilicus
Pancreas can hemorrhage

15

what is a metabolic derangement?

Electrolytes are way off
can become acidodic
blood sugar can shoot up due to lack of insulin

16

Big collections of air fluid levels can indicate what?

Ileus

17

Why are there not high pitched bowel sounds with an ileus

bowels aren't moving

18

5 "F's" for a GB problem

Fat
Fertile
Female
Forty
Fasting

19

What is the BEST test to find gallstones?

Ultrasound
shows stones, size, fluid, measurement of dilation

20

How long should they fast before a GB US?

4-6 hours
should be a lot of bile stored, helps you see it better

21

Imaging procedure used to diagnose problems in the liver, gallbladder and bile ducts.
a radioactive chemical or tracer is injected into a vein in your arm.
The tracer is handled by the liver like bile.

HIDA scan

22

What can the CT of GB show?

May show stones, but doesn't necessarily give you information about inflammation

23

If a person is very obese, what diagnostic method doesn't work as well?

Ultrasound

24

What is an ERCP

endoscopic retrograde cholangiopancreatography
diagnostic and therapeutic effect

25

Risk factors for gallstones

older, female
pima indians, and native amercians
obesity, rapid weight loss
cirrhosis
hemolytic anemia
diabetes

26

What does a cholangiogram do?

Put catheter in liver, can drip dye in there
if there is an obstruction can put in a T tube so bile can be drained

look for stones that wandered further in the duct

27

If a diabetic has gallstones what should you do?

Plan a surgery to have it out before there is a problem

28

Is chemical gallstone dissolution helpful?

Not really, as soon as stop the drugs stones come back

29

Will there be an acoustic shadow with GI sludge?

no

30

what are most cases of pancreatitis due to?

alcoholism and biliary tract dz

31

what meds can cause pancreatitis?

hydrocholorthiazide

32

what can cause pancreatitis?

ulcer
trauma
tumor
meds
meatbolic disorders

33

most common people to have acute pancreatitis

male alcoholism
females with gallstone

34

What disease increases risk of acute pancreatitis?

AIDS

35

Drugs that can cause acute pancreatitis?

thiazides, diuretics, gluco-corticosteroids, azathioprine, sulfasalazine, herbal remedies

36

what are metabolic causes of acute pancreatitis?

hypercalcemia
hypertriglyceridemia
heredity

37

With pancreatitis what will there be an elevation of what levels?

Serum isoenzymes

38

What can you look for in the urine for acute pancreatitis?

Trypsinogen-2

39

what will you experience w/ acute pancreatitis?

Diabetic ketoacidosis
enzymatic insufficiency
calcium imbalance
protein losses (ascities)
hemorrhage and volume loss

40

What often sits in the pancreas with pancreatitis?

calcium

41

chronic pancreatitis causes

Recurrent chronic alcoholics
biliary tract dz complications
hypercalcemia, hyperlipidemia
AIDS
thiazides

42

signs of pancreatitis

Band-like epigastric pain
Fever, N/V, Ileus

43

what labs will be elevated with pancreatitis?

Serum amylase
Lipase

44

IS ERCP helpful with pancreatitis?

Can be, but may exacerbate symptoms
Usually do after NPO and in hospital for a few days

45

How do you treat pancreatitis?

eliminate irritants (EtOH, fat, meds)
Hospitalize for IV hydration
NPO and NG suction
Antibiotics coverage for enterics
pain management, nutrition

46

when do you start IV fluids and antibiotics with acute pancreatitis

When >30% of tissue is necrotic

47

who is esophageal cancer common in?

smokers
alcoholics
Lye ingestions
advanced GERD

48

most common type of esophageal cancer?

Epidermoid (squamous cell)

49

Symptoms of esophageal CA

Reflux
Odynophagia
Dysphagia
Regurgitation
Inaition (the "blahs")

50

How does esophageal cancer spread?

Mucosa to mediastinum/ tachae
Regional nodes with rapid spread

51

what blood type is more likely to get cancer?

Type A blood

52

who is gastric CA common in

non-white
low socioeconomic status

53

what is gastric cancer related to

environment
food prep
nitrates

54

Risk factos for gastric Ca

H. pylori
previous gastric surgery (Bilroth II)
achlorhydria (inadequate acid)

55

Most common cell type for gastric cancer?

adenocarcinomas

56

some signs of gastric cancer

Iron deficiency anemia
Heme + stool
ascites
L Supra-clavicular node enlargement

57

mainstay for diagnostic of gastric cancer?

endoscopy with biopsy and brushing

58

ways to prevent gastric cancer

stop smoking/ alcohol
management of GERD
manage H. pylori
reduce nitrates in food prep

59

who are colon and rectal carcinomas common in?

males
increases with age

60

Is there a genetic connection with colon and rectal cancer?

yes, autosomal dominant familial adenomatous

61

in the eastern world where are colorectal cancers more common?

right side of the colon

62

more colorectal cancers develop from what type polyps?

adenomatous polyps

63

what is the difference between synchronus and metachornus neoplasia?

synchronus came about at the same time, near eachother
metachronus is the opposite

64

a polyp size greater than what has a worse prognosis?

1.5 cm

65

where do most metastases from colorectal cancer go?

Liver due to portal circulation

66

Risks with pancreatic cancer?

High alcohol and smoking habits
male
DM, chronic pancreatitic
dry cleaning and gasoline chemicals (may)

67

Symptoms of pancreatic cancer?

unexplained pain
weight loss
jaundice
depression
DVT

68

How do you diagnose pancreatic cancer?

ultrasound and CT
percutaneous fine needle aspiration
endo retro cholangio pancreatography

69

What are some cancer serum markers for pancreatic cancer?

CA 19-9
CEA

70

15 % of the time with an unprovoked DVT what will a patient have?

An undiagnosed malignancy somewhere because malignancy makes the blood hyper-coaguable

71

what part of the pancreas is pancreatic cancer likely to occur?

Head

72

why might a person with pancreatic cancer have painless jaundice?

common bile duct obstruction