Bile, Gallbladder and Gallstones

Question 1

Mrs Bilendy has been complaining of high temperature, right upper abdominal pain, and nausea. She was diagnosed as having gallstones and was referred to have her gallbladder removed which was successfully done at St George’s University Hospital. What type of diet must she be advised to adopt?

Answer 1

A low-fat diet

Question 2

List 2 functions of bile acids

Answer 2

Bile acids and phospholipids decrease the precipitation of cholesterol in the gallbladder by solubilising cholesterol
They facilitate the digestion of triacylglycerols, by making them accessible to pancreatic lipases
They eliminate cholesterol → bile acids and excrete in faeces
Control a number of metabolic processes- energy expenditure, control signalling events, glucose and lipid metabolism

Question 3

Which of the following is the most abundant bile acid?

Answer 3

Cholic acid

Question 4

Which of the following is a primary bile acid?

Answer 4

Cholic Acid

Question 5

Two different cell types secrete the components of bile. Name these cell types and their main secretions.

Answer 5

Hepatocytes: cholesterol, phospholipids (lecithin), bile pigments
Epithelial cells of bile ducts: bicarbonate-rich salt solutions

Question 6

Which of the following best describes the effects of secretin on the gallbladder?

Answer 6

Via stimulatory effects on the vagal nerve and on the gall bladder, it increases the bile, bicarbonate-rich and watery secretions of the gall bladder

Question 7

Which of the following best describes a bile salt?

Answer 7

Bile acid conjugated to taurine

Question 8

Gall stones can lodge in the opening of the gallbladder causing painful spasms of smooth muscles. This can prevent bile from entering the intestine thereby decreasing the absorption of fats which results in oily foul-smelling faeces. What is the medical term for the presence of excess fat in the faeces?

Answer 8

Steatorrhoea