Flashcards in Lesson 2A (Part 2) Deck (28)
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1
AST
Aspartate aminotransferase
- an enzyme
2
When is AST released?
When cells are injured or damaged
3
What is AST used for?
To diagnose liver disease before jaundice occurs
4
What is elevated levels of AST associated with? (3)
1. Cirrhosis
2. Hepatitis
3. Mononucleosis
5
What are 2 types of congenital anomalies/variants of the GB?
1. Duplication
- rare
2. Multiseptated
6
What is cholelithiasis?
A gallstone disease
7
What are the risk factors of cholelithiasis? (6)
1. Increasing age
2. Female
3. Fecundity(premenopausal women increased estrogen
- increase risk cholesterol levels and decrease GB contractions
4. Obesity
5. Diabetes
6. Pregnancy
8
What are 2 complications of cholelithiasis?
1. Biliary colic
2. Acute cholecystitis
9
What is the sonographic appearance of cholelithiasis?
Echogenic appearance with strong posterior acoustic shadowing
- small echogenic stones <5mm may not shadow
10
What is a key feature of stones allowing differentiation from polyps?
If they are mobile or not
- mobile = stones
- not mobile = polyps
11
WES
Wall echo shadow
12
How does WES complex work? (3)
1. Gallbladder wall is first visualized in the near field
2. Bright echo of the stone
3. Acoustic shadowing
13
What is milk of calcium bile?
Its is a rare condition where the GB is filled with semisolid calcium carbonate
14
What is milk of calcium bile caused by?
Stasis
15
What does milk of calcium bile rarely cause?
Acute cholecystitis
16
What does milk of calcium bile look like on US?
Forms a bile calcium level
17
How does biliary sludge appear?
1. As amorphous low-level echoes with no acoustic shadowing
2. Normal GB wall
18
What happens to the sludge when you change a persons body position?
It can move
19
What does biliary sludge lack?
Vascularity
20
What can tumefactive sludge (sludge balls) mimic?
Polyps
21
What is biliary sludge also known as? (2)
1. Biliary sand
2. Microlithiasis
22
What are predisposing factors of biliary sludge? (4)
1. Pregnancy
2. Rapid weight loss
3. Prolonged fasting
4. Critical illness
23
What are potential complications of biliary sludge? (3)
1. Biliary colic
2. Acalculous cholecystitis
3. Pancreatitis
24
What are the signs and symptoms of acute cholecystitis? (4)
1. RUQ pain that is constant
2. Epigastric pain
3. RUQ tenderness
4. Nausea/vomiting
25
What is acute cholecystitis caused by?
Stones
- 90% of the time
26
Who is affected more by acute cholecystitis?
Women
- 3x more likely
- <50 year old group
27
What can the impact of stones in the cystic duct or GB neck cause? (8)
1. Obstruction of bile flow
- intrahepatic duct dilatation
2. Luminal distension
3. Ischemia
4. Superinfection
5. Necrosis
6. Fever
7. Leukocytosis
8. Increased ALP & bilirubin
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