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Pathology > CH.5 Hepatobiliary System > Flashcards

CH.5 Hepatobiliary System Flashcards

1
Q

The hepatobiliary system is composed of what anatomy?

A
  • Liver
  • Gallbladder
  • Biliary tree
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2
Q

This is the largest solid organ in the body and receives blood supply from the hepatic artery and portal vein.

A

The Liver

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3
Q

The biliary tree consists of what?

A
  • Rt and Lt hepatic ducts
  • Common hepatic duct
  • Cystic Duct
  • Common Bile Duct
  • Pancreatic Duct
  • Ampulla of Vater
  • Sphincter of Oddi
  • Cholecystokinin
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4
Q

This is a pear-shaped sac found on the underside of the right surface of the liver. It has a neck, body, and fundus.

A

Gallbladder

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5
Q

This is an elongated flat organ that crosses to left side of abdomen and behind the stomach. It functions both endocrine and exocrine and contains the Islets of Langerhans.

A

Pancreas

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6
Q

This contrast study requires insertion of a Chiba needle directly into biliary tree by puncture of abdominal wall.

A

Percutaneous transhepatic cholangiography (PTC)

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7
Q

What can a PTC detect?

A
  • calculi or tumor in common bile duct

- can distinguish medical jaundice from surgical jaundice

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8
Q

What are the advantages to performing a PCT?`

A
  • High success rate

- Low complication rate

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9
Q

When is a PCT preferred?

A

When imaging hepatic duct bifurcation

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10
Q

What does ERCP stand for?

A

Endoscopic Retrograde Cholangiopancreatography

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11
Q

This contrast study is performed to visualize the biliary system and the main pancreatic duct. it is used in conjunction with CT or US of pancreas.

A

ERCP

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12
Q

Where is a catheter fed into for an ERCP?

A

Thin catheter is fed into the common bile duct or pancreatic duct from the duodenal c-loop.

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13
Q

What are ERCPs done to visualize?

A

Performed to visualize nondilated ducts, distal obstructions, or patients with bleeding disorders and pancreas.

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14
Q

This is a contrast study performed during surgery to detect biliarty calculi and common bile duct exploration.

A

Operative Cholangiography

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15
Q

During Operative Cholangiography where is the needle placed to inject contrast?

A

Into the cystic or common bile duct

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16
Q

This contrast study is perforrmed post operatively to check patency of the common bile duct and to check for the presence of calculi.

A

T-tube Cholangiography

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17
Q

Where is the contrast injected during a t-tube cholangiography?

A

Contrast is injected into a t-tube placed in the common bile duct

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18
Q

What is the modality of choice for evaluating gallbladder and the bilary tree?

A

Sonography

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19
Q

What are the benefits of CTs of the hepatobiliary system?

A
  • has excellemt contrast resolution
  • decreased exposure time
  • dynamic imaging of hepatobiliary system and blood flow.
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20
Q

This is a nuclear medicine noninvasive method to evaluate biliary drainage, hepatobiliary leaks following trauma or surgery and segmental obstruction.

A

Cholescintigraphy

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21
Q

What is used during a Cholescintigraphy?

A

technetium

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22
Q

What is the purpose of a cholescintigraphy?

A

Confirms cholecystitis and may distinguish acute vs. chronic cholecystitis.

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23
Q

MRi is often used in conjunction with CT to evaluate what?

A

-Peritoneum, especially liver and pancreas

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24
Q

This is a non invasive non contrast study using MR to visualize the gallbladder and biliary system and takes only about 15 secinds to aquire.

A

Magnetic Resonance Cholaniopancreatography (MRCP)

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25
Q

This refers to chronic destruction of liver cells and structure with nodular regeneration of liver and parenchyma and fibrosis. This is incurable and irreversible.

A

Cirrhosis

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26
Q

Cirrhosis is this type of liver disease and the major cause is what?

A
  • End-stage liver disease

- caused by chronic alcoholism (10-20 yrs alcohol abuse)

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27
Q

What are other causes of Cirrhosis?

A
  • Postnecrotic viral hepatitis
  • Hepatotoxic drugs and chemicals
  • Hemochromatiosis
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28
Q

What is the most common symptom of Cirrhosis?

A

Ascites, fluid accumulation in the abdomen

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29
Q

This modality is most used to evaluate fatty infiltrates and caudate and right lobes?

A

CT

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30
Q

This type of modality is most often used to evaluate portal hypertension and portosystemic collateral circulation.

A

US

31
Q

What are the types of treatments for inflammatory diseases of the Hematobiliary system?

A
  • Transplants

- Transjugular Intrahepatic Portosystemic Shunts (TIPSS)

32
Q

This in a relatively common inflammatory disease with at least 6 viral agents causing disease which interferes with the ability to excrete bilirubin.

A

Viral Hepatitis

33
Q

How many different forms are there of Viral Hepatitis?

A

6- A,B,C,D,E,G

34
Q

This type of Viral Hepatitis is spread through contaminated food or fecal matter. It is the most common and is highly contagious. It has a short incubation period and does not lead to chronic hepatitis or cirrhosis.

A

Hepatitis A (HAV)

35
Q

This type of Viral Hepatitis is transmitted parenterally by infected serum or blood products. It has a long incubation time and effects more severe than HAV. It may progress to chronic hepatitis and liver failure.

A

Hepatitis B (HBV)

36
Q

This type of Hepatitis is transmitted parenterally by RNA virus. 80% of hepatitis cases develop after blood transfusions and can cause either acute or chronic hepatitis with 10-20% of the cases leading to cirrhosis.

A

Hepatitis C (HCV)

37
Q

This type of viral hepatitis is transmitted parenterally by the RNA virus and occurs only concurrently with acute or chronic HBV. It cannot occur alone and can progress to chronic hepatitis.

A

Hepatitis D (HDV)

38
Q

This type of viral hepatitis is an RNA virus agent responsible for waterborne epeidemic acute hepatitis in developing countries. It does not progress to chronic hepatitis.

A

Hepatits E (HEV)

39
Q

This type of viral hepatitis was recently isolated and was trasmitted by blood products and may lead to chronic hepatitis.

A

Hepatitis G (HGV)

40
Q

This is another term for gallstones.

A

Cholelithiasis

41
Q

What are the 2 major types of gallstones?

A
  1. Cholesterol

2. Pigment- predominant in the US

42
Q

What are the predispositions associated withi gallstones?

A
  • family history
  • over 40
  • overweight
  • female
43
Q

This refers to calcification of the gallbladder walls. It is caused by chronic cholecystitis.

A

Porcelain Gallbladder

44
Q

This is an inflammatory process in which protein and lipid digest enzymes become activated within the pancreas and begin to digest the organ itself.

A

Acute Pancreatitis

45
Q

What is the most common cause of Acute Pancreatitis?

A
  • Excessive alcohol consumption

- other causes include obstruction of bile flow from a gallstone

46
Q

Cholelithiasis is commonly referred to as what?

A

Gallstones

47
Q

What are the two major types of gallstones?

A

Cholesterol and Pigment

48
Q

What is the imaging modality of choice in diagnosing gallstones?

A

Ultrasound

49
Q

What is pigment gallstones?

A

Come from bilirubin

50
Q

An inflammation of the gallbladder is known as?

A

Acute Cholelithiasis

51
Q

Cholelithiasis warrants what type of treatment?

A

Laprascopic surgery

52
Q

This refers to calcification of the gallbladder walls.

A

Porcelain Gallbladder

53
Q

Porcelain Gallbladder is caused by what?

A

Chronic Cholecystitis

54
Q

What occurs to the walls of the gallbladder during chronic cholecystitis to cause porcelain gallbladder?

A

The walls become fibrous then calcified.

55
Q

Patients with porcelain gallbladder are at a higher risk for what?

A

Colon Cancer

56
Q

What is the only treatment of porcelain gallbladder?

A

Removal of the gallbladder because it often becomes non-functioning

57
Q

This is an inflammatory process in which protein and lipid digesting enzymes become activated within the pancreas and begin to digest the organ itself.

A

Acute Pancreatitis

58
Q

This results when frequent injury to the pancreas causes scar tissue.

A

Chronic Pancreatitis.

59
Q

Recurring episodes usually result from chronic alcohol abuse which causes what to occur in the pancreas? (In regards to Chronic Pancreatitis)

A

It causes the gland to lose its ability to produce digestive enzymes, insulin, and glucagon.

60
Q

What are the 3 symptoms of chronic pancreatitis?

A
  • Pain
  • Malabsorption causing weight loss
  • Diabetes
61
Q

This is a metabolic sign of disease caused by excessive accumulation of bilirubin within the vascular system.

A

Jaundice

62
Q

What are the 2 types of Jaundice?

A
  • Medical which is non obstructive result of liver disease, treated medically.
  • Surgical which is obstructive result of cholelithiasis, treated surgically.
63
Q

What is the first clinical indication of jaundice?

A

The sclera of the eye will not be white, it will become yellow. The sclera is the whitest portion of the body.

64
Q

This is the most common tumor of the liver. They are benign.

A

Hemangioma

65
Q

This is primarily liver cell cancer and is most common in those with cirrhosis/

A

Hepatocellular Carcinoma

66
Q

This is the most common malignancy of the liver with very poor prognosis.

A

Hepatic Metastasis

67
Q

Hepatic Metastasis is spread from what other type of cancer?

A

GI cancers more specifically colon cancer

68
Q

What is the mode of spread causing hepatic metastasis?

A

Spreads via vascular system through the hepatic portal system vein.

69
Q

This type of neoplastic disease is infrequent but generally malignant. 85% are adenocarcinomas and 15% are anaplastic or squamous cell.

A

Carcinoma of the gallbladder

70
Q

What are the primary factors of carcinoma of the gallbladder.

A
  • Porcelain gallbladder

- Cholecystitis

71
Q

This is the 5th most common type of cancer death in the U.S. It usually advances at time of diagnosis with poor prognosis.

A

Cancer of the pancreas

72
Q

What is the most common type of cancer of the pancreas?

A

Adenocarcinoma

73
Q

What is the most common site of pancreatic cancer?

A

Head of pancreas

Pathology (10 decks)

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