HPB: revision cards Flashcards
(61 cards)
What is the pathogenesis of Gallstone formation? - list three factors
Interplay between bile supersaturation, nidus for crystal formation, and gallbladder hypomotility.
This refers to the processes that lead to the development of gallstones within the gallbladder.
What causes excess cholesterol concentration in bile?
Hepatic overproduction or relative reduction of bile salts or phospholipids.
These conditions can lead to the supersaturation of cholesterol in the bile.
What role does mucin composition play in gallstone formation?
Mucin is a glycoprotein that can facilitate the aggregation of cholesterol crystals, which then can act as a nidus for crystal formation.
How does biliary stasis contribute to gallstone formation?
Biliary stasis leads to prolonged retention of bile, increasing the likelihood of stone formation, via precipitation of nidus
.
What are the non-modifiable risk factors for Gallstone formation?
Genetic factors, Ethnicity, Increase age, Female gender, Oestrogen increases cholesterol secretion and diminishes bile salt secretion, Pregnant
Non-modifiable factors are those that cannot be changed or influenced by lifestyle choices.
List the modifiable risk factors for Gallstone formation.
- Lifestyle
- Obesity
- Diet high in cholesterol
- Diabetes
Modifiable factors can be influenced by changes in behavior or lifestyle.
True or False: Female gender is a non-modifiable risk factor for Gallstone formation.
True
Gender is a biological characteristic that cannot be changed.
Fill in the blank: Oestrogen increases cholesterol secretion and diminishes _______ secretion.
bile salt
This hormonal effect contributes to the risk of gallstone formation.
What effect does pregnancy have on Gallstone risk?
Increases risk due to hormonal changes
Hormonal fluctuations during pregnancy can influence gallstone formation.
What is the relationship between obesity and Gallstone formation?
Obesity is a modifiable risk factor
Reducing obesity can lower the risk of developing gallstones.
How does a diet high in cholesterol affect Gallstone formation?
It increases the risk of formation
High cholesterol intake is associated with gallstone development.
What role does diabetes play in Gallstone formation?
It is a modifiable risk factor
Managing diabetes can help reduce the risk of gallstones.
Which specific diseases increase the risk of stone formation?
Hyperbilirubinaemia, Cirrhosis, Ileal resections, Crohn’s disease
Specific pathologies that contribute to the risk of stone formation.
What are examples of conditions associated with Hyperbilirubinaemia?
Sickle cell, Thalassemia, Hereditary erythrocytosis
These conditions can lead to increased bilirubin levels, contributing to stone formation.
True or False: Cirrhosis is a disease that increases the risk of stone formation.
True
Cirrhosis is associated with metabolic changes that can lead to stone formation.
Fill in the blank: ________ resections can increase the risk of stone formation.
Ileal
Ileal resections can disrupt enterohepatic recirculation of bile salts
What gastrointestinal condition is linked with an increased risk of stone formation?
Crohn’s disease
This inflammatory bowel disease can lead to malabsorption and other metabolic changes affecting stone risk.
What percentage of bile acids are reclaimed via enterohepatic circulation?
Approx 90%
Where are primary bile acids synthesized?
In the liver
What is the role of the gallbladder (GB) in bile acid storage?
Stores and concentrates bile acids mixed with cholesterol, water, and phospholipids
What happens to primary bile acids after they are excreted in the duodenum?
They are broken down by intestinal bacteria to form secondary bile acids
How are bile acids reabsorbed in the small bowel?
Via passive transport in the jejunum and active transport in the ileum
What percentage of bile acids are reabsorbed in the terminal ileum (TI)?
Approx 95%
What do bile acids form to facilitate re-entry into the portal circulation?
Micelles
