Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MHD2 > Block 7 (GI) - Gallbladder Module > Flashcards

Block 7 (GI) - Gallbladder Module Flashcards

1
Q

What is inflammation of the gallbladder (acute or chronic)?

A

Cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is presence of stones within the biliary tree?

A

Choledocholithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the presence of gallstones in the gallbladder lumen?

A

Cholelithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is acute inflammation of the wall of bile ducts?

A

Cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 types of gallstones?

A
  1. Cholesterol stones

2. Pigmented bilirubin stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Compare the color of cholesterol and pigmented stones.

A

Cholesterol: yellow to tan
Pigmented: black or brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the components of cholesterol stones?

A

Mostly cholesterol + some calcium salts and mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the components of black stones?

A

Calcium bilirubinate, phosphate, carbonate, mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the components of brown stones?

A

Calcium bilirubinate, fatty acids, some cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of stone is most common?

A

Cholesterol (up to 80%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who is at risk for cholesterol stones?

A 
Female
>40 y/o
Fertile
Fat
Flatulant
History of intestinal disease or malabsorption
Familial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is at risk for black stones?

A

Patients with chronic hemolytic anemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who is at risk for brown stones?

A

Bacterial cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do cholesterol stones develop?

A

Bile formation is the only significant pathway to eliminate excess cholesterol from the body. When secreted by hepatocytes into bile, cholesterol is held in solution by bile acids and lecithin. If it contains too much cholesterol, it supersaturates and precipitates out.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is obesity related to development of cholesterol gallstones?

A

Obesity increases hepatic cholesterol secretion, leading to supersaturation of bile with cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is estrogen related to the development of cholesterol gallstones?

A

Estrogen increases hepatic cholesterol uptake and synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is hypomotility related to development of cholesterol gallstones?

A

A sluggish gallbladder promotes bile sludging and formation of tiny stones (nucleation) which develop into macroscopic stones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do black stones develop?

A

Unconjugated bilirubin is insoluble in bile and is normally present only in trace amounts. In diseases where there is increased unconjugated bilirubin, increased unconjugated bilirubin is secreted by hepatocytes. This precipitates as calcium bilirubinate, probably around a small focus of mucinous proteins, and grows into macroscopic black pigmented stones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do brown stones develop?

A

These stones form in the course of bacterial infections, causing deconjugation of bilirubin and in prolonged biliary stasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most gallstones are ___.

A

Asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common manifestation of symptomatic gallstones?

A

Biliary colic

22
Q

What are the symptoms of biliary colic?

A

Episodic abdominal pain in the epigastrum and/or RUQ, often radiating to the right shoulder and scapula; may have associated nausea or vomiting

Pain tends to intensify over ~15 minute, then decreases over the course of hours

23
Q

Biliary colic often develops after what?

A

Large or fatty meal

24
Q

Why does biliary colic develop?

A
  1. CCK released
  2. Gallbladder contracts
  3. Stone moves
  4. Stone blocks gallbladder outlet
  5. Increase in gallbladder pressure
  6. Pain
25
Q

Why does biliary colic resolve?

A
  1. Gallbladder relaxes
  2. Stones fall back into gallbladder
  3. Pressure relieved
  4. Pain resolves
26
Q

What causes 90% of acute cholecystitis?

A

Unrelieved obstruction fo the gallbladder by a gallstone

27
Q

What are the symptoms of acute cholecystitis?

A

Acute onset of RUQ pain, fever, leukocytosis, pain may radiate to right shoulder, lasts over 3 hours

28
Q

What may be seen on physical exam in acute cholecystitis?

A

Murphy Sign - arrest in inspiration during direct palpation of RUQ

29
Q

How is acute cholecystitis treated?

A

Cholecystectomy

30
Q

In 90% of cases of acute cholecystitis, gallstones obstruct the ___.

A

Cystic duct

31
Q

How does the gross gallbladder appear in acute cholecystitis?

A

Thickened wall, hyperemic, edematous, some necrosis

32
Q

What are potential complications of acute cholecystitis?

A

Bacterial superinfection, sepsis, perforation, cholecystoenteric fistula, bile stone ileus (impaction of a gallstone in the intestine)

33
Q

How does chronic cholecystitis present?

A

Vague, indistinct RUQ pain 1-2 hours after meals

34
Q

What are symptoms of choledocholithiasis?

A

Obstructive jaundice, abdominal discomfort, pruritis

35
Q

What is the typical set of symptoms seen in acute cholangitis?

A

Charcot triad - fever, jaundice, RUQ

36
Q

What is the definitive treatment for acute cholangitis?

A

Establish biliary drainage (relieve obstruction) with ERCP

37
Q

How do cholesterol stones appear on X-ray?

A

Radiolucent (cannot be seen on x-ray)

38
Q

What is the diagnostic study of choice when evaluating bilairy colic or cholecystitis?

A

Ultrasound

39
Q

What causes the other 10% of acute cholecystitis cases?

A

Acalculous cholecystitis (no gallstones, results from ischemia)

40
Q

Who tends to get acalculous cholecystitis?

A

People hospitalized with serious conditions (burns, sepsis, immunosuppression, major trauma, ischemia)

41
Q

What is a porcelain gallbladder?

A

Calcified gallbladder wall caused by long-standing inflammation; prone to developing gallbladder cancer

42
Q

What are the symptoms of gallbladder cancer?

A

Non-specific, may be similar to those of gallstone disease

43
Q

How does gallbladder cancer appear on histology?

A

Malignant glands infiltrate deeply into the muscularis

44
Q

Gallbladder cancer is usually infiltrative, leading to a ___ gallbladder wall.

A

Thickened and leathery

45
Q

What is a cholangiocarcinoma?

A

Cancer of the biliary tree

46
Q

___% of cholangiocarcinoma are intrahepatic; ___% are extrahepatic.

A

10; 90

47
Q

The majority of cholangiocarcinomas are ___.

A

Adenocarcinomas

48
Q

What is the most common clinical presentation of extra-hepatic cholangiocarcinomas?

A

Jaundice caused by complete obstruction of the biliary tree

49
Q

Periampullary tumors may present with what symptoms?

A

Obstructive jaundice, acute pancreatitis

50
Q

What is one of the most common micro-organisms cultured from bile in the setting of acute cholangitis?

A

E. coli

51
Q

Gallstones may serve as a persistent nidus of infection and risk for chronic carriage of this organism.

A

S. typhi

52
Q

Risk factor for cholangiocarcinoma, particularly in Asia (Thailand)

A

Chlonorchis sinensis

MHD2 (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions