gallbladder and biliary

Question 1

the gallbladder is located on the fossa on _____ ________ portion of the liver

Answer 1

posterior inferior

Question 2

the gallbladder can have a ____ of positions and the ___ ____ fissure is used as an identifying landmark

Answer 2

variety
main lobar

Question 3

the gallbladder is used as a storage sac for ____

Answer 3

bile

Question 4

the gallbladder shape can be ___, conical, ____ gourd-like, pear shaped

Answer 4

round
teardrop

Question 5

the gallbladder is a musculo-______ sac

Answer 5

membranous

Question 6

the gallbladder is located ____ to the right liver lobe. ___ to the right kidney and ____ to the pancreas head and duodenum

Answer 6

posterior
anterior
lateral

Question 7

normal gallbladder size in SAG is __-__ cm and in TRANS is ___ cm

Answer 7

7-10cm
3cm

Question 8

the normal gallbladder wall thickness is <___mm

Answer 8

3mm

Question 9

in the gallbladder the _____ is a hemispheric blind end, normally the most inferolateral portion that extends caudal and anterior below the inferior margin of the right hepatic love at the level of the 9th costal cartilage

Answer 9

fundus

Question 10

the neck of the gallbladder is in a fixed position at ____ ____ fissure

Answer 10

main lobar

Question 11

the gallbladders blood supply is from the ___ artery ( branch of the right hepatic artery )

Answer 11

Cystic

Question 12

the gallbladder blood drainage is from the ___ vein into the ___ venous system

Answer 12

cystic
portal

Question 13

the ____ duct connects the neck of the GB to the common hepatic duct

Answer 13

cystic duct

Question 14

the ____ duct contains spiral valves of Hester which prevent the GB from _____

Answer 14

cystic
collapsing

Question 15

the cystic duct is ____ to Gb neck and not normally seen on ultrasound

Answer 15

superior

Question 16

the cystic duct merges with the CHD to form the ____

Answer 16

CBD

Question 17

spiral valves of heister is found within the ___ duct. it controls inward and outward flow of bile and keeps duct from kinking

Answer 17

cystic duct

Question 18

the intrahepatic bile ducts is located within the liver anterior lateral to the ____ veins

Answer 18

Portal

Question 19

the intrahepatic bile ducts are the most ___ bile ducts

Answer 19

proximal

Question 20

the right and left intrahepatic ducts emerge to form the common hepatic duct at the level of the porta____

Answer 20

hepatic

Question 21

the common bile duct is formed by the union of the ___ ___ ___ and ____ ___

Answer 21

CHD
cystic duct

Question 22

the duodenal ____ is the opening into the duodenum

Answer 22

papilla

Question 23

_____ of ODDI controls flow of bile and pancreatic juices into duodenum

Answer 23

sphincter

Question 24

the _____ is used to store bile

Answer 24

gallbladder

Question 25

bile is a surfactant, emulsifier that breaks down ____ its made up of bile ___, ____ and a small amount of _____

Answer 25

fats salts cholesterol bilirubin

Question 26

in the gallbladder contractions are controlled by ______

Answer 26

cholecystokinin

Question 27

_____ is the main pigment found in bile

Answer 27

bilirubin

Question 28

bile is produced by the breakdown of ____

Answer 28

hemoglobin

Question 29

____ is responsible for color in feces

Answer 29

Bilirubin

Question 30

bilirubin pigment is associated with ____

Answer 30

jaundice

Question 31

the CBD ____ and concentrate bile

Answer 31

store

Question 32

the CBD deliver bile to the ______

Answer 32

duodenum

Question 33

the normal size of the CBD is __-___mm

Answer 33

1-4mm

Question 34

an increase of serum alkaline phosphate indicates mechanical obstruction to flow of _____

Answer 34

bilirubin

Question 35

______ cap Is a fold between the funds and body of gallbladder

Answer 35

Phrygian cap

Question 36

junctional fold also called _____ pouch is a fold between the body abdomen infundibulum of gallbladder its the most frequent variation

Answer 36

hartmann's

Question 37

normal gallbladder on ultrasound lumen is ____, wall is pencil ___ and echogenic the wall measurement taken in transverse of ____ wall and the normal length is no greater than ____mm

Answer 37

anechoic thin anterior 3mm

Question 38

biliary ___ is concentrated bile-thickened

Answer 38

sludge

Question 39

_____ ____ is sometimes a precursor to a stone formation

Answer 39

billiard sludge

Question 40

cholelithiasis is also known as _____

Answer 40

Gallstones

Question 41

cholelithiasis (gallstones) is more common in ____ (4;1) and ___% of the population will develop stones

Answer 41

women 10%

Question 42

the 5 F's of gallbladder disease is _____, ____, ____, ___ and ____

Answer 42

Female Fat Feritle Forty Fair

Question 43

some signs and symptoms of cholelithiasis ( gallstones) the patient may be ____ up to 60-80%. the patients generally present with RUQ pain that occurs after ___ or radiates to the upper ____, ____ or ___ area as well as nausea vomiting or intolerance to fatty foods

Answer 43

asymptomatic meals back shoulder epigastric

Question 44

with gallstones ___ and ___ are more costly

Answer 44

MRI CT

Question 45

____ sign is also known as double - arc shadow sign

Answer 45

WES sign

Question 46

The ___ ___ shows the contracted gallbladder containing stones

Answer 46

WES sign

Question 47

acute _____ ( inflammation of GB wall) up to 95% of cases result from impacted stones with GB neck or cystic duct

Answer 47

cholecystitis

Question 48

with acute cholecystitis patients present with RUQ pain that radiates to shoulder, the positive ____ sign ( rebound tenderness over the GB area ) , nausea , vomiting and fever

Answer 48

murphy

Question 49

acute cholecystitis may require ____ ___ ( life threatening )

Answer 49

emergency surgery

Question 50

_____ cholecystitis is caused by repeated attacks of ___ cholecystitis with subsequent ___ of the GB wall

Answer 50

chronic acute fibrosis

Question 51

chronic cholecystitis is a long term ____ of the GB due to infection , ____ or metabolic ____

Answer 51

inflammation obstruction disorders

Question 52

_____ gallbladder is a rare, calcium incrustation of the GB wall and a form of chronic cholecystitis

Answer 52

porcelain

Question 53

_____ is a benign proliferation of gallbladder wall tissue, it may be focal or diffuse and comet tail artifact may be seen due to trapped cholesterol stones in the RA sinuses and is usually asymptomatic

Answer 53

Adenomyomatosis

Question 54

GB _____ is progressive , rapidly spreading to other structures . Its also rare .Poor prognosis- mortality 100%

Answer 54

carcinoma

Question 55

GB carcinoma is usually seen in elderly and most commonly in ____ >60

Answer 55

woman

Question 56

GB carcinoma is highly associated with ___

Answer 56

cholelithiasis

Question 57

a bile duct ____ can be intrahepatic or extra hepatic location and is caused by stones, tumors within the bile ducts, or by a primary sclerosis cholangitis liver mass and pancreas disease

Answer 57

obstruction

Question 58

with a bile obstruction bile duct are dilated ____ to the obstruction level

Answer 58

proximal

Question 59

a biliary obstruction is suspected when patients present with _____

Answer 59

jaundice

Question 60

with biliary obstruction jaundice is caused by elevated _____

Answer 60

bilirubin

Question 61

the antler branching pattern or stellate branching pattern, the parallel channel sign, shotgun sign or too many tubes sign is seen with a biliary _____

Answer 61

obstruction

Question 62

choledocholithiasis is biliary obstruction caused by ____ in the bile ducts

Answer 62

stone

Question 63

_____ syndrome is when a stone is impacted in cystic duct of neck of GB

Answer 63

Mirizzi

Question 64

with ____ syndrome cholecystectomy is the preferred treatment

Answer 64

Mirizzi

Question 65

______ are enlarged lymph nodes in the areas of the porta hepatis and they can put pressure on the bile ducts and cause dilation in the proximal and intrahepatic ducts .

Answer 65

Lymphadenopathy

Question 66

Carcinoma in the head of the _____ may obstruct the distal CBD

Answer 66

pancreas

Question 67

with pancreatic head carcinoma all proximal ducts could become ____

Answer 67

dilated

Question 68

______ is a malignant neoplasm of bile ducts, most common are adenocarcinomas, followed by squamous

Answer 68

cholangiocarcinoma

Question 69

there are ____ types of cholangiocarcinoma

Answer 69

3

Question 70

The 3 types of cholangiocarcinoma are _____ ( peripheral) ______ ( most common ; develops outside the CBD) ____ - klatskin's tumor ( located between left and right hepatic ducts causes intrahepatic dilation)

Answer 70

Intrahepatic Distal Hilar

Question 71

the subtypes of cholangiocarcinoma are _____ - most common ____ - most common _____- found in distal CBD

Answer 71

sclerosing nodullar papillary

Question 72

the most common subtypes of cholangiocarcinoma are ____ ____

Answer 72

nodular sclerosing

Question 73

_____ tumor is cholangiocarcinoma at the right and left hepatic bifurcation, dilation is only of the intrahepatic ducts, Lack of joining of left and right hepatic ducts

Answer 73

Klatskin's

Question 74

choledochal cyst type 5 is ____ disease which is multiple cysts

Answer 74

Caroli's

Question 75

____ disease is a congenital anomaly its usually asymptomatic first 5-20 years its a segmental saccular cystic dilation of major intrahepatic ducts

Answer 75

Caroli's

Question 76

Caroli's disease can appear as a ___ of ___

Answer 76

string of beads

Question 77

the central dot sign is associated with ___ ___-

Answer 77

Caroli's disease

Question 78

____ is inflammation of the bile ducts

Answer 78

cholangitis

Question 79

there are 4 types of cholongitis - ____ cholangitis - primary _____ cholangitis - ___ related cholangitis - recurring ____ cholangitis

Answer 79

bacterial sclerosing AID's pyogenic

Question 80

main cause of ___ is biliary failure secondary to percutaneous biliary procedures or other biopsies

Answer 80

Hemobilia

Question 81

_____ is air within the biliary tree secondary to biliary intervention, Biliary-enteric anastomoses, or common bile duct stents

Answer 81

Pneumobilia