11.2 - Gall bladder and biliary tract

Question 1

how does biliary atresia present?

Answer 1

jaundice (conjugated bilirubin)

Question 2

does biliary atresia involve the intra- or exrahepatic biliary tree?

Answer 2

extrahepatic

Question 3

how do cholesterol stones appear on XR?

Answer 3

radiolucent

Question 4

how does clofibrate lead to gall stones?

Answer 4

lipid lowering agent that increases HMG CoA reductase activity, leading to:

• increased cholesterol produced
• decreased conversion of cholesterol to bile acids (cholesterol is less soluble leading to stones)

Question 5

which stones are pigmented?

Answer 5

bilirubin

Question 6

which worms can cause bilirubin stones?

Answer 6

• ascaris lumbricoides

- clonorchis sinensis

Question 7

is the serum alk phos level elevated or depressed in acute cholecystitis?

Answer 7

elevated

Question 8

what is a rokitansky-aschoff sinus?

Answer 8

herniation of gall bladder mucosa into muscular wall

Question 9

porcelain gall bladder is a late complication of what condition?

Answer 9

chronic cholecystitis

Question 10

herniation of gall bladder mucosa into muscular wall

Answer 10

rokitansky-aschoff sinus

Question 11

ascending cholangitis is due to what type of flora?

Answer 11

enteric gram negative bacteria (ascending infection)

Question 12

what is the cause of gall stone ileus?

Answer 12

due to cholecystitis with fistula formation between gall bladder and small bowel - gall stone can block ileocecal valve

Question 13

how does gall bladder carcinoma classically present?

Answer 13

elderly woman with cholecystitis