Gallstones Flashcards
1
Q
symptoms of gallstones
A
- RUQ, shoulder and chest pain
- food intolerance
- belching, bloating
- diarrhea, N/V
- often after a fatty meal
- often awakens from sleep with pain
2
Q
cholesterol stones
A
- majority of gallstones
- radiolucent
- yellow-green
- Decrease 7-alpha-hydroxylase = increased cholesterol and decreased bile salts leads to increased cholesterol gallstones
3
Q
excess of cholesterol
A
- pregnancy, obesity, estrogen, TPN, Fasting (gastric surgery)
4
Q
depletion of bile salts
A
- Pima Indians, distal small bowel disease
5
Q
aspirin and gallstones
A
- removes gallstone disease with excess mucin
6
Q
most important factor in formation of gallstones
A
- gallbladder stasis
7
Q
black stones
A
- usually occur in gallbladder, occasionally in bile duct
- occur with hemoglobinopathies, cirrhosis, alcoholism, pancreatitis, and TPN
- occurs in a STERILE environment
- mostly salt of unconjugated bilirubin - hard stones
8
Q
brown stones
A
- soft stones, usually in the ducts
- from infected environment
- bacterial cell bodies found at the core
9
Q
complications of gallbladder disease
A
- acute cholecysitis
- cholangitis
- Mirizzis syndrome
- gallstone pancreatitis
10
Q
cholangitis
A
- Charcots triad, Reynolds pentad
11
Q
Charots triad
A
- RUQ pain, fever, jaundice
12
Q
Reynolds pentad
A
- Charcots, encephalopathy, shock
13
Q
Mirizzis syndrome
A
- stone in cystic duct causing occlusion of CBD
- elevated liver enzymes
14
Q
sphincter of Oddi dysfunction
A
- papillary stenosis
- biliary dyskinesia
- treat with ERCP
15
Q
papillary stenosis
A
- choledochal sphincter or sphincter of Oddi fibroses causing inability to relax with CCK or glucagon
