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Flashcards in Gallstones Deck (24):
1

List risk factors for gallstones

Age >40
Female
Pregnancy
OCP/ estrogen therapy
obesity
rapid weight loss
Crohns disease
Hemolysis

2

Hemolysis causes _______ gallstones

pigmented

3

Jaundice due to hemolytic anemia causes what changes in bilirubin levels?

Greater increase in unconjugated than conjugated bilirubin

4

Jaundice due to hepatitis causes what changes in bilirubin levels?

Similar increase in both conjugated and unconjugated bilirubin

5

Jaundice due to biliary duct stone causes what changes in bilirubin levels?

Greater increase in conjugated than unconjugated bilirubin

6

Bile is composed of:

Water, Bile acids, Phospholipids, Electrolytes, Cholesterol, Bilirubin

7

List three key features of biliary stone formation

supersaturation
crystal nucleation
stasis/ hypomotility
= cholelithiasis

8

List 6 conditions/ clinical manifestations of biliary stone formation

1) Symptomatic cholelithiasis
2) Acute cholecystitis
3) Chronic cholecystitis
4) Choledocholithiasis
5) Gallstone pancreatitis
6) Cholangitis

9

What is the treatment for symptomatic cholelithiasis?

cholecystectomy

10

How is acute cholecystitis diagnosed on MRI?

thickened gall bladder wall, pericholecystic fluid

11

What is the treatment for acute cholecystitis?

cholecystectomy

12

What are possible outcomes if cholecystectomy is not performed on a patient with acute cholecystitis?

perforation
gangrene

13

Describe the presentation of chronic cholecystitis

post-prandial RUQ pain, nausea
normal LFTs/CBD
fibrotic/ thickened gallbladder wall due to chronic irritiation
invariably associated with cholelthiasis

14

How is chronic cholecystitis treated

cholecystectomy

15

It is important to recognize porcelain gallbaldder because of the significant risk of _______

gallbladder cancer
tx= cholecystectomy

16

What is choledocholithiasis?

gallstones in duct, can occur even after cholecystectomy

17

What is the treatment for choledocholithiasis?

ERCP with stone extraction, sphincterotomy

18

What are possible complications of choledocholithiasis?

acute cholangitis
gallstone pancreatitis

19

Describe the presentation of gallstone pancreatitis

severe constant epigastric pain radiating to back
elevated WBCs, elevated bilirubin/ ALKP/ ALT/AST/ amylase/ lipase
CT with peri-pancreatic inflammation, dilated bile ducts, cholelithiasis

20

What is the treatment for gallstone pancreatitis?

IV fluids and medically stabilize
ERCP stone extraction

21

List key symptoms that suggest acute cholangitis

RUQ pain, fever, jaundice, hypotension, mental status changes

22

Describe the findings seen in acute cholangitis

Elevated WBCs, LFTs
MRCP shows common bile duct full of stones, obstruction of biliary tree, and purulent fluid filling biliary tree

23

List bacteria commonly implicated in acute cholangitis

E coli, Klebsiella, Enterobacter species

24

How is acute cholangitis managed?

Medical support including IV antibiotics, biliary drainage (via ERCP or PTC)