Gallbladder/Biliary Tract Disorders Flashcards Preview

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Flashcards in Gallbladder/Biliary Tract Disorders Deck (46)
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1

Hormone responsible for release of bile into duodenum

CCK

2

Which duct temporarily stores bile in the gallbladder?

cystic duct

3

formation of gallstones (choleliths) which are solid concretions of varying quantities of cholesterol, ca+, and bilirubin which usually form in the GB

cholelithiasis

4

What leads to the formation of cholesterol stones?

Supersaturation of bile with cholesterol and GB hypomotility

5

How do you differentiate between polyp and gallstone on ultrasound?

stone will cast a shadow whereas a polyp will not

6

Treatment for symptomatic cholelithiasis

cholecystectomy

7

stone erodes through GB wall and develops a cholecystoenteric fistula leading to obstruction of narrowest segment of bowel

gallstone ileus

8

Known protective factor for gallstones

statins

9

The presence of gallstones within the CBD. LFT’s (ALT, AST) are elevated, bilirubin and alk phos may be elevated

choledocholithiasis

10

Treatment recommendation of choledolithiasis to prevent acute cholangitis, acute pancreatitis, and hepatic abscesses

removal of all bile duct stones

11

Gold standard for diagnosis of CBD stones, and sphincter of Oddi dysfunction

Endoscopic Retrograde Cholangiopancreatography (ERCP)

12

Detects choledocholithiasis, neoplasms, strictures, biliary dilations. Minimally invansive, but cannot sample bile, test cytology, remove stone

Magnetic resonance cholangiopancreatography (MRCP)

13

A syndrome of RUQ pain that may radiate to right shoulder, fever, and leukocytosis associated with gallbladder inflammation usually caused by cystic duct obstruction. often occurs after fatty meal

acute cholecystitis

14

main cause of acute cholecystitis

impacted gallstone

15

Physical exam manuever that is useful for differentiating pain in the right upper quadrant. positive in cholecystitis, but negative in choledocholithiasis

Murphy's sign

16

The imaging modality of choice for the gallbladder. fast, real-time, non-invasive, and does not utilize ionizing radiation

abdominal ultrasound

17

What does slow uptake of HIDA indicate?

hepatic parenchymal disease

18

What does filling of GB/CBD w/delayed or absent filling of intestine with HIDA indicate?

obstruction of ampulla

19

What does non-visualization of GB w/ filling of the CBD and duodenum with HIDA indicate?

cystic duct obstruction and acute cholecystitis

20

Describe a normal HIDA scan

Early filling of the GB at 15 minutes and complete filling by 25 minutes

21

Preferred treatment for acute cholecystitis

laproscopic cholecystectomy

22

A rare form of acute cholecystitis, which occurs when air appears in the GB wall 2ndry to infection w/ gas forming anerobes. Associated with DM

emphysematous cholecystitis

23

Gender differences between emphysematous cholecystitis and acute cholecystitis

Men are affected twice as commonly as women in emphysematous cholecystitis, where as the reverse is true in most cases of acute cholecystitis

24

RUQ pain that comes and goes, may be referred to right shoulder or right scapula, subsides in 30 minutes. Usually precipitated by a fatty meal. N/V but no fever and WBC normal

chronic cholecystitis

25

Extensive calcium encrustation of the gallbladder wall and blue appearance of gallbladder. common manifestation of chronic cholecystitis

porcelain gallbladder

26

Cancer associated with porcelain gallbladder

adenocarcinoma

27

Primarily cause of acute cholangitis

bacterial infection

28

Most important presdisposing factor for acute cholangitis

biliary obstruction and stasis secondary to biliary calculi (CBD stone) or benign stricture

29

What are the components of Charcot's triad?

RUQ pain, jaundice, and fever/chills

30

life threatening sepsis this is a bacterial infection superimposed on an obstruction of the biliary tree most commonly from a gallstone, but it may be associated with neoplasm or stricture

septic cholangitis