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KaBoom > Biliary System - Part 6 > Flashcards

Biliary System - Part 6 Flashcards

1
Q

What is the 5th most common malignancy?

A

GB carcinoma

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2
Q

What are the risk factors for GB carcinoma? (5)

A
  1. Cholelithiasis
  2. Porcelain GB
  3. Cholecystitis
  4. Female prevalence
  5. Greater than 60 years of age
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3
Q

What are the clinical findings for GB carcinoma? (8)

A
  1. Asymptomatic
  2. RUQ pain
  3. Palpable mass
  4. Jaundice
  5. Anorexia
  6. Nausea/vomiting
  7. Elevated alkaline
    phosphatase
  8. Mild increase in AST and ALT levels
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4
Q

What is the US appearance for GB carcinoma? (6)

A
  1. Thick, irregular GB wall
  2. Irregular intraluminal mass
  3. Immobile mass
  4. Cholelithiasis
    - 90% of cases
  5. Lymphadenopathy
  6. Metastatic liver lesions
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5
Q

What are 5 differential diagnosis for GB carcinoma?

A
  1. Adenoma
  2. Sludge
  3. Cholecystitis
  4. Adenomyomatosis
  5. Metastases
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6
Q

Is GB carcinoma more common in male or females?

A

Females

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7
Q

What are the direct extensions of metastatic GB disease? (3)

A
  1. Pancreas
  2. Stomach
  3. Bile duct
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8
Q

What are the indirect extensions of metastatic GB disease? (4)

A
  1. Melanoma
    - most common
  2. Lung
  3. Kidney
  4. Esophagus
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9
Q

What are the clinical findings for metastatic GB disease? (5)

A
  1. Asymptomatic
  2. RUQ pain
  3. Jaundice
  4. Nausea/vomiting
  5. Elevated alkaline
    phosphatase
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10
Q

What is the US appearance for metastatic GB disease? (3)

A
  1. Focal GB wall thickening
  2. Irregular intraluminal mass
  3. Non-shadowing
  4. Absence of gallstones
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11
Q

What are 3 differetial diagnosis for metastatic GB disease?

A
  1. Cholecystitis
  2. Adenoma
  3. Primary carcinoma
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12
Q

What are the complications of acute cholecystitis? (5)

A
  1. Ascending cholangitis
  2. Empyema
  3. Perforation
  4. Pericholecystic
    or liver abscess
  5. Septicemia
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13
Q

What are the causes of acute cholecystitis? (3)

A
  1. Obstruction of the cystic duct
  2. Infection
  3. Idiopathic
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14
Q

What are the risk factors of acute cholecystitis? (3)

A
  1. Female prevalence
  2. Cholelithiasis
  3. 40-50 years of age
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15
Q

Is acute cholecystitis more common in male or females?

A

Females

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16
Q

What are the clinical findings of acute cholecystitis? (7)

A
  1. Severe epigastric or RUQ pain
  2. Biliary colic
  3. Positive Murphy sign 4. Nausea/vomiting
  4. Fever and chills
  5. Elevated AST, bilirubin, and alkaline phosphatase
  6. Leukocytosis
17
Q

What is the US appearance of acute cholecystitis? (7)

A
  1. Thick, edematous GB wall
    - “halo sign”
  2. Impacted stone in the cystic duct or GB neck
  3. Cholelithiasis
    - 90% of cases
  4. Pericholecystic fluid
  5. Positive Murphy sign
  6. Peripheral hyperemia on colour
    Doppler
  7. Sludge
18
Q

What are 3 differential diagnosis for acute cholecystitis?

A
  1. Liver abscess
  2. Ascites
  3. Non-fasting patient
19
Q

What are causes of emphysematous cholecystitis? (2)

A
  1. Cholelithiasis

2. Idiopathic

20
Q

What are the clinical findings of emphysematous cholecystitis? (4)

A
  1. RUQ pain
  2. Nausea/vomiting
  3. Fever
  4. Leukocytosis
21
Q

What is the US appearance of emphysematous cholecystitis? (4)

A
  1. Echogenic focus(i) within the GB wall or lumen
  2. Ill-defined posterior acoustic shadowing
  3. Cholelithiasis
  4. Pericholecystic fluid
22
Q

What are 4 differential diagnosis of emphysematous cholecystitis?

A
  1. Acute cholecystitis
  2. Porcelain GB
  3. Large gallstone
  4. Intestinal air
23
Q

What are the risk factors for gangrenous cholecystitis? (3)

A
  1. Diabetes
  2. Older adult
  3. Male prevalence
24
Q

What are the clinical findings for gangrenous cholecystitis? (5)

A
  1. RUQ pain radiating to the back
  2. Positive Murphy sign
  3. Fever
  4. Leukocytosis
  5. Elevated AST, bilirubin, and
    alkaline phosphatase
25
Q

What is the US appearance for gangrenous cholecystitis? (4)

A
  1. Diffuse echogenic focus within the lumen
  2. Immobile
  3. Non-shadowing
  4. Non-layering
26
Q

What are 4 differential diagnosis for gangrenous cholecystitis?

A
  1. Acute cholecystitis
  2. Emphysematous cholecystitis
  3. Adenoma
  4. Carcinoma
27
Q

Is gangrenous cholecystitis more common in males or females?

28
Q

What are the risk factors for GB perforation? (5)

A
  1. Diabetes
  2. Older adult
  3. Infection
  4. Cholelithiasis
  5. Trauma
29
Q

What are the clinical findings for GB perforation? (5)

A
  1. RUQ mass
  2. Severe RUQ or epigastric pain
  3. Positive Murphy sign 4. Nausea/vomiting
  4. Leukocytosis
30
Q

What is the US appearance for GB perforation? (3)

A
  1. Edematous, thick GB wall

2. Pericholecystic fluid 3. Cholelithiasis

31
Q

What is the 3 differential diagnosis for GB perforation?

A
  1. Ascites
  2. Hepatic
    abscess
  3. Perforated peptic ulcer

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