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Patho Exam #4 > Alterations in Function of the Gallbladder and Exocrine Pancreas > Flashcards

Alterations in Function of the Gallbladder and Exocrine Pancreas Flashcards

1
Q

Also called gallstones

A

Cholelithiasis

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2
Q

*Etiology
Native Americans > American Caucasians
Women > men (2:1)
Adults: May be asymptomatic and not need treatment

Children: Usually from an underlying condition and need gallbladder removed

A

Cholelithiasis

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3
Q

Biliary colic

type of _____Cholelithiasis

A

chronic

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4
Q

Related to intermittent obstruction of cystic duct

Precipitated by a meal (infrequent schedule)

A

Biliary colic

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5
Q

Persistent epigastric or right upper abdominal pain, often radiates to back
Nausea, vomiting, sweating, flatus

A

Biliary colic

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6
Q

Increases steadily for >15 minutes, lasts several hours, then slowly decreases
Fatty food intolerance, belching, bloating, and epigastric burning

A

Biliary colic

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7
Q

Chronic Cholelithiasis diagnoses is _____

A

ultrasound

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8
Q

Watchful waiting
Cholecystectomy (surgical removal of the gallbladder)
treatment for ________

A

Chronic Cholelithiasis

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9
Q

Chemical dissolution of gallstones
Lithotripsy (mechanical breaking up of gallstones within the gallbladder)
Treatment for _______

A

Chronic Cholelithiasis

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10
Q

Inflammation of the gallbladder wall

Causes fibrosis and thickening

A

Cholecystitis

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11
Q

*Related to continued presence of gallstones
*2 types
Acute
Chronic

A

Cholecystitis

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12
Q

Acute inflammation of the gallbladder wall

A

Acute Cholecystitis

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13
Q

Present in 90% of patients
Obstruction of cystic duct present in almost all patients: related to stasis of bile
Bacterial infection may be present

A

Acute Cholecystitis

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14
Q

If untreated, escalates; gangrene may occur

A

Acute Cholecystitis

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15
Q

Rupture
Peritonitis
can occur from _____

A

Acute Cholecystitis

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16
Q

Septic shock
Localized abscess (empyema)
Cholecystoenteric fistula (fistula between gallbladder and GI tract)
can occur from ______

A

Acute Cholecystitis

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17
Q

Severe right upper abdominal pain: radiates to back; abdominal tenderness; fever;

A

Acute Cholecystitis

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18
Q

leukocytosis, mild elevations of bilirubin and serum transaminases

A

Acute Cholecystitis

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19
Q

Abdominal ultrasound
Presence of stones
Thickened gallbladder wall
to diagnose

A

Acute Cholecystitis

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20
Q

HIDA scan, CT, MRCA, ERCP

to diagnose

A

Acute Cholecystitis

21
Q

Laproscopic cholecystectomy: mainstay of therapy

for

A

Acute Cholecystitis

22
Q

Antibiotics (if bacterial infection)
Percutaneous catheter drainage or endoscopic drainage with stent placement (obstruction
used to treat

A

Acute Cholecystitis

23
Q

Gangrene, empyema, or emphysematous changes: surgical emergencies
for

A

Acute Cholecystitis

24
Q

Pain management
Chemodissolution (nonsurgical): use of bile acids/organic solvents to dissolve gallstone
Lithotripsy (nonsurgical)
Breaking up of gallstones using shockwaves
Stones <2 cm
treatment for

A

Acute Cholecystitis

25
Q

(nonsurgical): use of bile acids/organic solvents to dissolve gallstone

A

Chemodissolution

26
Q

(nonsurgical)
Breaking up of gallstones using shockwaves
Stones <2 cm

A

Lithotripsy

27
Q

Occurs in patients without preexisting gallstones

Males >50 years

A

Acalculous cholecystitis

28
Q

Tends to occur in the setting of major surgery, critical illness, trauma, burn-related injury, or TPN
Rapid development of gangrene, perforation, emphysematous cholecystitis, and empyema

A

Acalculous cholecystitis

29
Q

Acalculous cholecystitis a type of _____cholecystitis

A

acute

30
Q

Inflammation of the pancreas

Autodigestion of the pancreas from enzyme activation

A

Acute Pancreatitis

31
Q

Predisposing factors

Biliary tract disease, hypertriglyceridemia, ethanol-associated (66%)

A

Acute Pancreatitis

32
Q

3 pathways
Obstruction of the pancreatic duct by a stone or other cause (usually unknown)
Acinar cell injury
Defective intracellular transport

A

Acute Pancreatitis

33
Q 
Steady, boring pain in epigastrium or LUQ
Increases in intensity
Severe tenderness on palpation
Radiates or penetrates to back
Nausea and vomiting
symptoms of
A

Acute Pancreatitis

34
Q

Abdominal distention
Hypoactive bowel sounds
Low-grade fever
symptoms of

A

Acute Pancreatitis

35
Q

WHATS THE PREFERRED TEST FOR ACUTE PANCREATITIS

A

lipase

36
Q

Increase in amylase and lipase during first 12 hr (indictative)
Elevated aminotransferases, alkaline phosphatase and bilirubin
used to diagnose

A

Acute Pancreatitis

37
Q

*Abdominal x-ray
Ileus pattern; “sentinel loop”: distended loop of small bowel in area of pancreas
*Abdominal ultrasound
used to diagnose

A

Acute Pancreatitis

38
Q

GOLD STANDARD to diagnose Acute Pancreatitis

A

CT of abdomen

39
Q

*Reduce pancreatic secretions
*Conservative management
*Withhold oral feedings
treatment for

A

mild to moderate acute pancreatitis

40
Q

*Nasogastric suction for adynamic ileus
*IV fluid replacement
*Analgesics
treatment for

A

mild to moderate acute pancreatitis

41
Q

*Usually in ICU
*Nutritional replacement: prevents tissue breakdown, may need TPN
treatment for

A

severe pancreatitis

42
Q

*Calcium and magnesium administration
*Control of hyperglycemia (insulin)
*Prevent respiratory failure, acute renal failure, intraabdominal sepsis
treatment for

A

severe pancreatitis

43
Q

*Mechanical ventilation and hemodialysis may be needed
*Bacterial infection: antibiotics and aspirate fluid cultured; usually indicates poor prognosis
*Surgical intervention (abscess or hemorrhage)
Necrosectomy: debridement of devitalized tissue
Pancreatectomy: major pancreatic resection
Drains usually present

treatment for

A

severe pancreatitis

44
Q

debridement of devitalized tissue; used to treat

A

Necrosectomy; severe pancreatitis

45
Q

major pancreatic resection; used to treat

A

Pancreatectomy; severe pancreatitis

46
Q

_____ is a collection of fluid within or adjacent to pancreas

Complication of _____-

A

Pseudocyst; acute pancreatitis

47
Q

________ is a persistent leak in pancreatic duct into pleural space and mediastinum. Complication of ______

A

Pancreatic ascites; acute pancreatitis

48
Q

Painless and massive
Detected by ultrasound or CT, fluid analysis obtained by aspiration
Treatment: prolonged parenteral nutrition, stent

A

Pancreatic ascites

49
Q

Fever, tachycardia, abdominal mass, and tenderness

Management: endoscopic or surgical drainage

A

pseudocyst

Patho Exam #4 (7 decks)

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