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Flashcards in Gallstones Deck (54)
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1

What is the prevalence of gallstones and related diseases.

They are present in 7% of men and 15% of women aged 18-65.
The overall prevalence is 11%.
They are rare before the 3rd decade.

2

What does bile consist of. (3)

Cholesterol.
Bile salts.
Lecithin.

3

What are the types of gallstone. (3)

Cholesterol.
Pigment.
Mixed.

4

What is biliary colic.

It is pain due to the temporary impaction of a stone in the gall bladder neck or cystic duct.
It is a severe, constant pain, that has a crescendo characteristic.

5

What are the symptoms of biliary colic. (3)

Usually pain begins in the epigastrium, but there may be RUQ pain.
The pain may radiate to the tip of the right scapula.
Vomiting/nausea.

6

What is the physical signs of biliary colic.

Tender RUQ.

7

What is cholecystitis.

An impacted stone obstructing the gall bladder outlet, which may result in infection of the accumulating bile.
In 95% of cases, a gallstone is found to be the cause.

8

What are the symptoms of acute cholecystitis. (6)

Constant RUQ or epigastric pain.
There may be referred pain to the tip of the right scapula.
Fever.
Vomiting.
Local peritonism.
Gallbladder mass.

9

What are the physical signs of cholecystitis. (4)

Pyrexia.
Tenderness.
Rebound and guarding in RUQ.
Murphy's sign: patient catches their breath on inspiration when two fingers are placed in the RUQ. (only valid if same test is negative in LUQ)

10

What are the anatomical locations that can develop complications due to gallstones. (3)

Gall bladder.
Biliary tree.
Bowel.

11

What are the potential complications of gallstones in the gall bladder. (4)

Biliary colic.
Cholecystitis (acute and chronic)
Empyema.
Mucocele.
Carcinoma.
Mirizzi's syndrome.

12

What are the potential complications of gallstones in the biliary tree. (3)

Obstructive jaundice.
Pancreatitis.
Cholangitis.

13

What is the potential complication of gallstones in the bowel.

Gallstone ileus.

14

What is gallstone obstructive jaundice.

Gallstone impacts in, and obstructs the common bile duct.

15

What are the symptoms of gallstone obstructive jaundice. (5)

Jaundice.
Pale stools.
Dark urine.
Pruritus.
Symptoms of biliary colic, or painless.

16

What are the signs of gallstone obstructive jaundice. (2)

Jaundice.
There may be tenderness in the RUQ.

17

What is ascending cholangitis.

Gallstone impacted in the common bile duct, resulting in infection of the biliary system.

18

What are the symptoms of ascending cholangitis. (6)

Pale stools.
Dark urine.
Pruritus.
Charcot's triad: Jaundice, RUQ pain, fever.

19

What are the signs of ascending cholangitis. (3)

Pyrexia.
RUQ tenderness.
Rigors.

20

What is gallstone ileus.

Gallstone erodes through into the duodenum.
It may cause a mechanical bowel obstruction.

21

What is normally seen biochemically with cholestasis.

Elevated ALP.
If it is severe there will also be elevated bile acid levels and elevated bilirubin.

22

What is cholestasis due to.

It results from an abnormality of bile flow.

23

What is meant by the term 'biliary disease'

It relates to pathology at any level from the small intrahepatic bile ducts to the sphincter of oddi.

24

Does biliary disease and cholestatic disease always occur together.

There is a very significant overlap between the two, but there are situations in which cholestasis can exist without biliary disease, and situations in which biliary disease can exist without cholestasis.

25

Give examples of pathology when cholestatis disease occurs without biliary disease. (2)

Transporter disease.
Drug induced cholestasis.

26

Give an example of pathology when biliary disease occurs without cholestasis.

When disease of the bile duct does not impact on bile flow.

27

Are gallstones more common in men or women.

Under 40, there is a 3:1 female preponderance.
In the elderly, the sex ratio is about equal.

28

Where are cholesterol gallstones more common.

In developed countries.

29

Where are pigmented gallstones more common.

In developing countries.

30

What do the majority of gallstones consist of.

They are of mixed composition. (cholesterol and pigment).