Gallbladder Path II Flashcards Preview

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Flashcards in Gallbladder Path II Deck (22):
1

acute cholecystitis

common
-majority from gallstones
dehydration - AIDS infection - cryptosporidium > CMV

2

disease model of blockage

acute obstruction

stone impaction - increased pressure behind obstruction and ischemia

bacterial infection - invasive of mucosa - can penetrate and perforate

gangrenous necrosis - compression of wall vessels

3

sonographic murphys sign

gallstones

4

ultrasound gallstones

see shadows

5

HIDA scan

nuclear study
-IV dye to liver
-to biliary tree
-fills gallbladder normally
-then seen in small bowel

if obstruction
-no dye to gallbladder

acute or chronic cholecystitis with stone formation

6

ERCP

endoscopic retrograde cholangiopancreatography

risks - pancreatitis

scope inserted to small bowel - tip of scope - instrument that has light, needle with catheter (to biliary tree) - to inject dye

can also examine pancreatic duct

identify stones, tumors, carolis disease, PSC

can grab and remove stones

and also needle and core biopsies

7

red mucosa of gallbladder

with inflammation
-this hurts

if white - no inflammation

8

hydrops of gallbladder

obstruction of cystic duct with no inflammation - but creates thick mucous

inspissation

9

inspissation

mucous more viscous by extracting water

10

acute/ascending cholangitis

stasis/obstruction of biliary tract

secondary bacterial infection - e. coli, klebs, entero

move up biliary tree into liver bile duct system - can lead to liver abscesses

11

charcots triad

fever
jaundice
abdominal pain

with ascending cholangitis

12

reynolds pentad

fever, jaundice, abdominal pain, hypotension, mental status change

with ascending cholangitis - increased mortality

13

tx ascending cholangitis

drainage with ERCP
remove obstruction

14

chronic cholecystitis

majority associated

repeated bouts of acute inflammation

15

rokitansky aschff sinus

stiff, thick walls with variable inflammation of gallbladder

chronic cholecystitis

surface mucosa pulled down into wall of gallbaldder

glands surrounded by inflammatory cells

16

porcelain gallbladder

chronic cholecystitis with calcified wall

higher risk of adenocarcinoma

NEED SURGERY**

xray visible

CAT scan - white wall calcifications

17

carcinoma of gallbladder

common - adenocarcinoma

from cells of mucosa**

glands -and holes

women, 60-70yo
native americans

with stones and chronic inflammation

bad prognosis

18

adenocarcinoma of gallbladder

rarely diagnosed when resectable

bad prognosis

19

ERBB2 - her-2 neu overexpression

adenocarcinoma of gallbladder

20

cholangiocarcinomas

of bile ducts

in liver or extrahepatic ducts

21

klatskin tumor

junction of right and left hepatic duct cancer

cholangiocarcinoma

22

liver flukes

can be cause of cholangiocarcinoma