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KaBoom > Biliary System - Part 2 > Flashcards

Biliary System - Part 2 Flashcards

1
Q

What are 3 anatomical variants of the GB?

A
  1. Hartmann pouch
  2. Junctional fold
  3. Phrygian cap
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2
Q

Hartmann pouch

A

Small posterior pouch near the GB neck

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3
Q

Junctional fold

A

Fold or septation of the GB at the junction of the neck and body

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4
Q

Phrygian cap

A

Fold in the gallbladder fundus

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5
Q

What are 5 congenital anomalies of the GB?

A
  1. Agenesis
    - rare
  2. Duplication
  3. Hypoplasia
  4. Intrahepatic or ectopic
  5. Multiseptated
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6
Q

What is hypoplasia of the GB associated with?

A

Cystic fibrosis

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7
Q

What is the normal length and diameter of the GB in fasting adult?

A
  1. Length = 8=10cm

2. Diameter = 3-5cm

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8
Q

What is the normal length and width of the GB in a fasting in a pediactric patient?

A
  1. Length = 1.5-3cm

2. Width = 1.2cm

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9
Q

What is the normal length and diameter of the GB in a fasting in a patient between the ages of 2-16 years old?

A
  1. Length = 3-7cm

2. Diameter = 1-3cm

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10
Q

What is the US appearance of a fasting GB? (2)

A
  1. An ellipsoid anechoic structure located in the GB fossa demonstrating posterior acoustic enhancement
  2. Smooth hyper echoic walls
    - measuring 3mm or less in thickness
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11
Q

Where is the GB located compared to the liver?

A

Inferior medial aspect of the liver

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12
Q

What are 6 reasons on why you wouldn’t see a GB?

A
  1. Non-fasting patient
  2. Surgically absent
  3. Obliteration of the GB lumen by intestinal air or gallstones
  4. Patient body habitus
  5. Ectopic location
  6. Agenesis
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13
Q

What are 6 non-inflammatory causes of GB wall thickening?

A
  1. Non-fasting patient
  2. Ascites
  3. Cirrhosis
  4. Congestive heart failure
  5. Hypoalbuminemia
  6. Acute hepatitis
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14
Q

What can be used to decrease artifactual echoes in the GB? (2)

A
  1. Harmonics
  2. Dynamic range
    - compression
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15
Q

How can spatial compounding help?

A

It can help to visualize structures posterior to a highly attenuating structure

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16
Q

If the patient is in a jaundice state, what part of the biliary system should be evaulated?

A

Intrahepatic ducts

17
Q

What are 7 indications for scanning the biliary system?

A
  1. RUQ pain
    - may radiate to the upper back and chest
  2. Increase in LFTs
  3. Nausea/vomiting
  4. Intolerance to fatty foods
  5. Postprandial pain
  6. Positive Murphy sign
  7. Jaundice.
18
Q

Alkaline phosphatase

A

An enzyme produced primarily by the liver, bone and placenta and excreted
through the bile ducts

19
Q

What is the normal range of alkaline phosphatase?

A

35-150 U/L

20
Q

What does an increase in alkaline phosphatase indicate?

A

Obstructive jaundice

21
Q

ALT

A

Alanine aminotransferase

22
Q

Alanine aminotransferase

A

An enzyme found in high concentration in the liver and in lower concentrations in the heart, muscle, and kidney

23
Q

What is the normal range of ALT?

A

1-45U/L

24
Q

Does ALT or AST remain elevated longer?

A

ALT

25
Q

What does an elevation of ALT associated with? (3)

A
  1. Cirrhosis
  2. Hepatitis
  3. Biliary obstruction
26
Q

What does a mild elevation of ALT associated with?

A

Liver metastasis

27
Q

AST

A

Aspartate Aminotransferase

28
Q

Aspartate Aminotransferase

A

An enzyme present in many types of tissue that is released when cells are injured or damaged
- levels will be proportional to amount of damage and the time between cell injury and testing

29
Q

What is the normal range for AST?

A

1-36U/L

30
Q

What does an elevation of AST associated with? (3)

A
  1. Cirrhosis
  2. Hepatitis
  3. Mononucleosis
31
Q

Bilirubin

A

A product from the break down of Hb in old RBCs

  • a disruption in the process may cause abnormal levels
  • leakage into tissues gives the skin a yellow appearance
32
Q

What is the normal range of total bilirubin?

A

0.3-1.1mg/dL

33
Q

What is the normal range of direct bilirubin?

A

0.1-0.4mg/dL

34
Q

What does bilirubin reflect on?

A

The balance between production and excretion of bile

35
Q

What is an elevation of direct on conjugated bilirubin associated with? (4)

A
  1. Obstruction
  2. Hepatitis
  3. Cirrhosis
  4. Liver metastasis
36
Q

What is an elevation of indirect on unconjugated bilirubin associated with?

A

Non-obstructive conditions

KaBoom (81 decks)

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