acute cholecystitis Flashcards

1
Q

definition

A

inflam of the gallbladder caused by stone lodged in cystic duct

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2
Q

risk factors

A

women, obese, increased age, highest in mex/americans, hypertriglyceridemia may promote gallstones

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3
Q

cause

A

gets signal to secrete bile to help w/ digestion, gallbladder contracts and stone gets stuck, as the stuck increases bile becomes an irritant, mucosa secretes mucus and enzymes, bacterial growth starts

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4
Q

S&S

A
pain starts in epigastric then RUQ radiates to shoulder, dull achy pain
peritonitis
fever
leukocytosis
vomit
rebound tenderness/guarding
jaundice
\+ murphys sign
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5
Q

where does pain start and then radiate to

A

starts in the epigastric area, then RUQ radiates to the shoulder

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6
Q

quality of pain

A

dull achy

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7
Q

diagnosis

A

US confirms, HIDA, ercp, mrcp, ct

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8
Q

US confirms by seeing what

A

sludge, bile duct distention, gallbladder wall thickening

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9
Q

diff

A

perforated peptic ulcer, acute pancreatitis, appy, perforated diverticulum, liver abscess, hepatitis, pna, myocardial ischemia

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10
Q

complications

A

gangrene and chronic cholecystitis

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11
Q

when does gangrene happen

A

24-48 hrs suggest severe inflammation and poss gangrene which can lead to perforation and abscess

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12
Q

treatment

A

Admit: npo, ivf, anagesic
iv abx: 2nd/3rd gen: cephalosporin: + flagyl
admit
monitor for gangrene, US guided aspiration delay sx, cholecystectomy within 24 hrs of admit

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