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Abdomen Pathology > Gallbladder Pathology > Flashcards

Gallbladder Pathology Flashcards

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1
Q

What is the most common cause of gallbladder wall thickening?

A

cholecystitis

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2
Q

Causes of gallbladder wall thickening

A

cholecystitis, adenomyomatosis, cancer, AIDS/HIV

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3
Q

Pericholecystic fluid is seen with?

A

acute cholecystitis

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4
Q

Gallbladder pathology is due to?

A

metabolic factors, stasis, inflammation

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5
Q

Choledochal cyst

A

outpouching of ductal walls due to relfuxing of enzymes

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6
Q

What is the most common form of a choledochal cyst?

A

fusiform dilatation of the CBD

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7
Q

Choledochal cyst type V is also known as?

A

Caroli’s Disease

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8
Q

Caroli’s disease

A

nonobstructive saccular dilatation of intrahepatic ducts

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9
Q

Caroli’s disease is more common in?

A

adults

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10
Q

Signs and symptoms of Caroli’s disease

A

jaundice, displacement of stomach and duodenum

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11
Q

Choledochal cysts are more common in?

A

children

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12
Q

Sludge

A

bile that coagulates; can lead to stones

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13
Q

Signs and symptoms of sludge

A

RUQ pain

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14
Q

What is the main cause of sludge?

A

prolonged fasting

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15
Q

Sonographic appearance of sludge

A

tends to layer, low level echoes, viscous, mobile, no shadow

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16
Q

Tumefactive sludge give the appearance of a?

A

pseudotumor

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17
Q

Sonographic appearance of tumefactive sludge

A

does not layer, sludge balls, mobile, echogenic, non shadowing

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18
Q

Sonographic appearance of cholelithiasis

A

mobile, echogenic foci, shadowing, gravity dependant

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19
Q

Which lab value is elevated with cholelithiasis?

A

ALP

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20
Q

6 Fs of cholelithiasis

A

Fat, Female, Fair, Forty, Fertile, Flatulent

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21
Q

WES sign

A

wall, echogenicity, shadow; gallbladder full of stones

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22
Q

With the WES sign, which part of the lumen is seen?

A

anterior

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23
Q

Bile duct obstruction causes an elevation in which lab values?

A

bilirubin and ALP

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24
Q

Signs and symptoms of bile duct obstruction

A

RUQ pain, jaundice, fever

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25
Bile duct obstruction causes what sign?
double barrel, double duct
26
Choledocholithiasis can lead to?
cholangitis
27
Choledocholithiaisis causes an elevation in which lab values?
direct bilirubin, ALP, transaminase
28
The CBD is considered enlarged when it measures larger than?
7 mm
29
What is the most common inflammatory condition of the gallbladder?
acute cholecystitis
30
Signs and symptoms of acute cholecystitis
**positive Murphy's sign**, RUQ pain, nausea, vomiting, fever
31
What lab values are elevated with acute cholesystitis?
ALP, leukocytosis, hyperbilirubinemia
32
Sonographic appearance of acute cholecystitis
wall thickening, enlarged gallbladder, may have stones, pericholecystic fluid, hyperemia
33
Acute acalculous cholecystitis
acute cholecystitis with no stones
34
Signs and symptoms of AAC
RUQ pain, **positive Murphy's sign**, nausea, vomiting
35
Sonographic appearance of AAC
enlarged gallbladder with wall thickening, pericholecystic fluid
36
Empyema is also called?
Suppurative cholecystitis
37
Suppurative cholecystitis
pus in gallbladder
38
Empyema is more common in?
diabetics
39
Signs and symptoms of empyema
RUQ pain, **fever, chills**
40
Empyema can resemble?
sludge
41
Gallbladder perforation can result from?
acute cholecystitis
42
Gallbladder perforation usually occurs in which portion?
fundus
43
Signs and symptoms of gallbladder perforation
RUQ pain, vomiting, **fever, leukocytosis, abnormal LFTs**
44
Sonographic appearance of gallbladder perforation
defect in wall, complex fluid collection, irregular wall
45
Gangrenous cholecystitis
ischemic or necrotic wall due to lack of blood flow or infection
46
What kind of patients are more at risk for gangrenous cholecystitis?
diabetics
47
Sonographic appearance of gangrenous cholecystitis
thick irregular wall, gas or air in wall or lumen, ring down artifact
48
Emphysematous cholecystitis
gas in wall, lumen, pericholecystic space, or ducts from bacteria
49
Which patients are more at risk for emphysematous gallbladder?
men; diabetics
50
Sonographic appearance of emphysematous cholecystitis
gas appears as **echogenic foci in wall or lumen, mobile, non gravity dependant**, ring down or comet tail
51
Chronic cholecystitis is more common in?
women; elderly
52
What lab values are elevated with chronic cholecystitis?
ALP, AST, ALT, and bilirubin if jaundiced
53
Sonographic appearance of chronic cholecystitis
wall thickening, small gallbladder, cholelithiaiss
54
Bouveret syndrome
stones goes through gallbladder and into duodenum
55
Mirizzi syndrome
stone in cystic duct or neck causing compression on adjacent duct
56
Jaundice is also called?
icteric
57
Porcelain gallbladder
wall is calcified due to extensive inflammation
58
Porcelain gallbladder can lead to?
carcinoma
59
Porcelain gallbladder is more common in?
elderly women
60
Sonographic appearance of porcelain gallbladder
echogenic line with acoustic shadowing obscuring the gallbladder; gallstones are usually present
61
With dilated intrahepatic ducts, the obstruction is always ______ to the obstruction
proximal
62
Radicals cause an increase in which lab value?
ALP
63
Cholesterol polyp
benign growth of cholesterol
64
Sonographic appearance of a polyp
echogenic, fixed, no shadow, **stalk**
65
Differenc between adenoma and polyp
adenoma has no stalk
66
Primary gallbladder carcinoma begins as?
polyp, porcelain gallbladder, or chronic cholecystitis
67
Gallbladder carcinoma can be caused by METS from?
pancreatic cancer
68
Adenomyomatosis
excessive proliferations of surface epithelium with diverticula or outpouchings into lumen
69
Adenomyomatosis is also called?
Rokitansky-Aschoff sinuses
70
Adenomyomatosis is more common in?
women
71
Sonographic appearance of adenomyomatosis
comet tail with twinkle artifact; zig zag stripes, wall thickening
72
Strawberry gallbladder is also called?
cholesterolosis
73
Cholesterolosis
abnormal cholesterol deposits in wall; associated with gallstones
74
Strawberry gallbladder is more common in?
women
75
Sonographic appearance of cholesterolosis
fixed, no shadow, echogenic foci (seeds)
76
Courvousier gallbladder
**palpable**,enlarged, nontender, gallbladder in a jaundiced patient
77
Courvousier gallbladder is caused by?
extrinsic compression of CBD
78
Most common cause of Courvousier gallbladder
mass at pancreatic head
79
Hydropic gallbladder
abnormally distended gallbladder
80
Most common cause of hydropic gallbladder
stone in neck or cystic duct
81
Sonographic appearance of a hydropic gallbladder
round, distended, **thin wall**
82
Cholangiocarcinoma
primary malignancy in bile ducts
83
Klatskin tumor is a type of?
cholangiocarcinoma
84
Klatskin tumors cause dilation of the?
intrahepatic ducts
85
Klatskin tumors are located where?
at the junction of the right and left intrahepatic duct
86
Signs and symptoms of cholangiocarcinoma
icterus, palpable gallbladder, anorexia, fatigue
87
Cholangitis
inflammation or fibrosis of the ducts
88
Cholangitis causes an increase in which lab values?
ALP, AST, ALT, leukocytosis, and direct bilirubin with jaundice
89
Pneumobilia
gas/air in biliary tree; caused by surgery or infection
90
Pneumobilia causes what artifact?
dirty shadowing
91
Which type of gallbladder perforation is more common? What forms with it?
subacute; abscess

Abdomen Pathology (7 decks)

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