Lesson 2A (Part 2) Flashcards Preview

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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

28

What is the sonographic appearance of acute cholecystitis? (8)

1. Gallstones
2. Thickening GB wall
- > 3mm
3. Edematous
- differentiation of layers
4. Distention of GB lumen
- >4cm transverse
5. Impacted stone of CD or GB
6. Pericholecystic fluid collection
7. Hyperemic wall
- vascular (peripheral)
8. Intrahepatic duct/CBD dilation