UW Cholestasis and gallstone ileus

Question 1

what cells produce CCK?

Answer 1

produced by I cells

Question 2

what intestines produce CCK?

Answer 2

duodenum and jejunum

Question 3

what is trigger for CCK?

Answer 3

fat-protein-rich chyme enters the duodenum

Question 4

CCK functions?3

Answer 4

increase pancreatic enzyme secretion (by acinar cells) and gallbladder contraction, and to decrease gastric emptying.

Question 5

Cholestasis is defined as a decrease in bile flow due to impaired secretion by hepatocytes or to obstruction of bile flow through intra-or extrahepatic bile ducts.

Answer 5

.

Question 6

Intrahepatic causes of cholestasis?

Answer 6

Drug induced (erythromycin, contraceptives);

Primary biliary cholangitis

Cholestasis of pregnancy

Primary sclerosing cholangitis (may also be extraheptic)

Question 7

Extrahepatic causes of cholestasis?

Answer 7

Choledocholithiasis
Malignancy (pancreatic, gallbladder)

Question 8

What cholestasis? Drug induced (erythromycin, contraceptives).

Answer 8

Intrahepatic

Question 9

What cholestasis? Primary biliary cholangitis

Answer 9

Intrahepatic

Question 10

What cholestasis? Cholestasis of pregnancy

Answer 10

Intrahepatic

Question 11

What cholestasis? Primary sclerosing cholangitis (may also be extraheptic)

Answer 11

Intrahepatic

Question 12

What cholestasis? Choledocholithiasis

Answer 12

Extrahepatic

Question 13

What cholestasis? Malignancy (pancreatic, gallbladder)

Answer 13

Extrahepatic

Question 14

Cholestasis can arise secondary to ….

Answer 14

Hepatocellular dysfunction or intrahepatic or extrahepatic biliary obstruction.

Question 15

Both obstructive and nonobstructive cholestasis are characterized by?

Answer 15

deposition of bile pigment within the hepatic parenchyma, often with green-brown plugs in the dilated bile canaliculi.

Question 16

When cholestasis is prolonged, what can expect?

Answer 16

When it is prolonged, the reduction in bile flow causes intestinal malabsorption of fats and fat-soluble vitamins (A, D, E, and K), which require bile salts for digestion.

Question 17

Gallstone ileus epidemiology?

Answer 17

elderly women

Question 18

Gallstone ileus. Size of stone?

Answer 18

typically >2.5 cm

Question 19

Gallstone ileus. Gallstone cause formation of what?

Answer 19

cholecystoenteric fistula between the gallbladder and adjoining gut (most often the duodenum) due to pressure necrosis and erosion of these tissues.

Question 20

Gallstone ileus. Cholecystoenteric fistula is formed between what structures?

Answer 20

between the gallbladder and adjoining gut (most often the duodenum) due to pressure necrosis and erosion of these tissues.

Question 21

Gallstone ileus. Why occurs cholecystoenteric fistula?

Answer 21

due to pressure necrosis and erosion of these tissues.

Question 22

Gallstone ileus. where stone is trapped?

Answer 22

in the ileum (ILEOCECAL VALVE), the narrowest portion of the intestine

Question 23

Gallstone ileus. manifestation?

Answer 23

Abdominal pain/distension, nausea/vomiting, high-pitched (tinkling) bowel sounds, and tenderness to palpation.

Question 24

Gallstone ileus. abdominal x ray?

Answer 24

may reveal dilated loops of bowel with air-fluid levels due to intestinal obstruction.

Question 25

Gallstone ileus. What gas related finding could occur?

Answer 25

Communication between the intestine and gallbladder may also allow gas to enter the biliary tree (pneumobilia).