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ABD Board Review > Biliary Tract > Flashcards

Biliary Tract Flashcards

1
Q

calcification of gb wall associated with chronic cholecystitis

A

porcelain GB

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2
Q

majority of patients with biliary obstruction have pathology where?

A

distal CBD

most common lesions are gallstones and carcinoma of pancreas head

elevated alk phos, conjugated bilirubin, gamma glutamyl transpeptidase

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3
Q

cholangiocarcinoma located at the hepatic hilum

A

klatskin tumor

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4
Q

hepatic causes of jaundice

A

acute liver inflammation

chronic liver disease

infiltrative disease

inflammation of bile ducts

genetic disorders

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5
Q

chronic cholecystitis

A

chronic GB disease characterized by recurring symptoms of biliary colic due to multiple previous episodes of acute cholecystitis. sono findings same as acute

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6
Q

Fold between the body and neck (infundibulum) of the GB

A

junctional fold

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7
Q

most common cause of extrahepatic obstructive jaundice

A

choledocholithiasis

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8
Q

extrahepatic biliary obstruction due to an impacted stone in the cystic duct causing compression on the CHD

A

mirizzi syndrome

findings: intrahepatic dilatation, stone, curved segmental stenosis of CHD, cholecystocholedochal fistula

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9
Q

overdistended gb filled with mucoid or clear, watery contents

A

hydrops of gb

bile is reabsorbed and gb filled instead from secretion of mucosa

AKA mucocele

asymptomatic

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10
Q

congentital bile duct anomaly consisting of cystic dilatation of the intra or extrahepatic bile ducts. five classes of cysts.

A

choledochal cysts

prevalent in Asia

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11
Q

emphysematous cholecystitis

A

due to GB wall ischemia and infection

gas produced by aneorbic bacteria, found in wall, lumen, or biliary tree

reverberation or comet-tail artifact

diabetic men

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12
Q

GB perforation

A

localized fluid collection in the GB

peritonitis, pericholecystic abscess, biliary fistula

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13
Q

type V choledochal cyst. associated with congenital hepatic fibrosis, portal hypertension, renal tubular ectasia

A

caroli’s disease

multiple cysts converge toward the porta hepatis communicating with the bile ducts

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14
Q

enlarged nondiseased gb due to mechanical obstruction of the CBD associated with pancreatic adenocarcinoma at the head

A

courvoisier GB

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15
Q

in acute cholecystitis, amylase elevation suggests obstruction where?

A

ampulla of Vater

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16
Q

total bilirubin

A

conjugated bilirubin + unconjugated bilirubin

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17
Q

most common cause of GB wall thickening

A

cholecystitis

hypoalbuminemia, ascites, hepatitis, congestive heart failure, pancreatitis

18
Q

empyema of the gallbladder

A

purulent material within the GB due to bacteria-containing bile associated with acute cholecystitis

19
Q

choledocholithiasis complications

A

biliary cirrhosis

cholangitis

pancreatitis

20
Q

hyperplastic changes involving the GB wall causing overgrowth of the mucosa, wall thickening, and fomation of diverticula

A

adenomyomatosis

21
Q

post hepatic jaundice

A

obstruction of biliary tree

22
Q

cholangiocarcioma

A

typically originate within extrahepatic bile ducts

predisposing condition of primary sclerosing cholangitis is most common

intrahepatic duct dilatation

jaundice, weight loss, abd pain

23
Q

lipids are deposited in the GB wall. condition referred to as strawberry GB

A

cholesterolosis

vary in size, can be as large as 1 cm

24
Q

bacterial infection superimposed on an obstruction of the biliary tree

A

cholangitis

25
Q

galstones are composed of what

A

cholesterol

calcium bilirubinate

calcium carbonate

26
Q

GB carcinoma

A

intraluminal mass

asymmetric wall thickening

mass that fills GB

27
Q

hormone released into blood by ingestion of fatty foods, caused by gallbladder contraction

A

cholecystokinin

28
Q

primary sclerosing cholangitis

A

inflammation and fibrosis of the intra and extrahepatic duct

results in liver failure

thickened bile duct walls, cirrhosis

29
Q

sludge like material with high concentration of calcium

A

milk of calcium bile (limy bile)

layering of sludge

30
Q

gallbladder wall inflammation due to cystic duct obstruction by a gallstone. RUQ pain, fever, and leukocytosis

A

acute cholecystitis

gallstones, murphys sign, gallbladder dilatation, sludge

31
Q

Hartmann’s pouch

A

an abnormal sacculation (diverticulum) of the neck of the GB

32
Q

air in the biliary tract commonly associated with endoscopic retrograde cholangiopancreatogram (ERCP)

A

pneumobilia

33
Q

prehepatic causes of jaundice

A

hemolysis

ineffective erythropoiesis

absorption of large amounts of hemoglobin

34
Q

end product of hemoglobin breakdown

A

bilirubin

35
Q

gallbladder polyps

A

<10mm unlikely to be cancerous

>10mm more likely

36
Q

primary biliary cirrhosis

A

chronic and progressive cholestasis due to destruction of the small intrahepatic ducts leading to end stage liver disease

etiology unknown

ultrasound findings nonspecific

37
Q

CBD in relation to the duodenum and pancreatic head

A

passes posterior

38
Q

surgical drainage with the Kasai portoenterostomy is most successful in the treatment of what?

A

biliary atresia

39
Q

what is GB sludge composed of

A

calcium bilirubinate granules and cholesterol crystals

40
Q

common duct measurement

A

<5mm normal

in elderly patients, one mm per decade rule

age 60, normal 6mm duct

postcholecystecomy up to 10mm

41
Q

acute cholecystitis without the presence of gallstones. typically secondary event in critically ill hospitalized patients

A

acalculous cholecystitis

sonofindings: wall thickening, murphys sign, pericholecystic fluid

42
Q

lab value specific to bile duct obstruction

A

alkaline phosphatase

ABD Board Review (8 decks)

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