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ARRT (Abdominal US) > Chapter 3 Gallbladder > Flashcards

Chapter 3 Gallbladder Flashcards

1
Q

Calcifications of the gallbladder wall is termed

A

Porcelain gallbladder

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2
Q

_____ is associated with courvoisier gallbladder

A

Pancreatic head mass

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3
Q

The spiral valves of Heister are found within the

A

Cystic duct

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4
Q

Cholesterol crystals within the Rokitansky Aschoff sinus are found with:

A

Adenomyomatosis

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5
Q

Diabetic patients suffering from acute cholecystitis have an increased risk for developing

A

Emphysematous cholecystitis

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6
Q

Focal tenderness over the gallbladder with probe pressure describes

A

Murphy sign

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7
Q

A nonmobile, nonshadowing focus is seen within the gallbladder lumen. This most likely represent a

A

Gallbladder polyp

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8
Q

Intermittent obstruction of the cystic duct by a gallstone results in

A

Chronic cholecystitis

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9
Q

_______ would be the least likely finding of acalculous cholecystitis

A

Cholelithiasis (gallstones)

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10
Q

The sequela of acute cholecystitis that is complicated by gas within the gallbladder wall is

A

Emphysematous cholecystitis

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11
Q

The champagne sign is associated with

A

Emphysematous cholecystitis

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12
Q

Tumefactive sludge can resemble the sonographic appearance of

A

Gallbladder carcinoma

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13
Q

Clinical findings of adenomyomatosis

A

Asymptomatic

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14
Q

WES sign denotes

A

A gallbladder filled with cholelithiasis (stones)

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15
Q

Acute cholecystitis that leads to NECROSIS and abscess development within the gallbladder wall describes

A

Gangrenous cholecystitis

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16
Q

The diameter of the gallbladder should not exceed

A

5cm

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17
Q

The most common variant of gallbladder shape is the

A

Phrygian cap

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18
Q

What is/are cholelithiasis?

A

Gallstones

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19
Q

Empyema of the gallbladder denotes

A

Gallbladder filled with pus

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20
Q

The gallbladder is connected to the biliary tree by the

A

Cystic duct

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21
Q

The outermost layer of the gallbladder wall is the

A

Serosal layer

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22
Q

The innermost layer of the gallbladder wall is the

A

Mucosal layer

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23
Q

The cystic artery is most often a direct branch of the

A

Right hepatic artery

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24
Q

The middle layer of the gallbladder wall is the

A

Fibromuscular layer

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25
Q

Which structure is a useful landmark for identifying the gallbladder

A

Main lobar fissure

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26
Q

What hormone causes the gallbladder to contact

A

Cholecystokinin

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27
Q

The gallbladder wall should measure not more than

A

3mm

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28
Q

The direct blood supply to the gallbladder is the

A

Cystic artery

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29
Q

At which level of the gallbladder is the junctional fold found

A

Neck

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30
Q

Which part of the gallbladder is involved in Hartmann pouch

A

Neck

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31
Q

_____ is associated with cholelithiasis and is characteristically found in Africans or people of African descent

A

Sickle cell disease

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32
Q

Hepatization of the gallbladder occurs when the gallbladder

A

Fills with sludge

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33
Q

______ is suspected if a polyp or mass within the gallbladder measures greater than 1cm

A

Gallbladder carcinoma

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34
Q

The diffuse polypoid appearance of the gallbladder referred to as strawberry gallbladder is seen with

A

Cholesterolosis

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35
Q

Causes of nonvisualization of the gallbladder (8):

A
  1. Cholecystectomy
  2. Gb filled with stones
  3. Postprandial
  4. Chronic cholecystitis
  5. Ectopic location
  6. Agenesia
  7. Hepatization of the gallbladder (sludge)
  8. Air-filled gallbladder or emphysematous cholecystitis
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36
Q

Acute cholecystitis can turn into

A

Gangrenous cholecystitis

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37
Q

Patients often complain of focal tenderness over the gallbladder with transducer pressure when the gallbladder is inflamed this is termed

A

Positive Murphy sign

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38
Q

The most common cause of acute cholecystitis is

A

Gallstone lodged in the cystic duct or neck of the gallbladder

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39
Q

The sudden onset of gallbladder inflammation is referred to as

A

Acute cholecystitis

40
Q

An enlarged gallbladder can be caused by a blockage of

A

Cystic duct or other parts of the biliary tree

41
Q

______ are the most common type of polyps

A

Cholesterol

42
Q

________ which is a group of proliferated and degenerative gallbladder disorder, includes both adenomyomatosis and cholesterolosis

A

Hyperplastic cholecystosis

43
Q

Sonographic findings of polyps (1):

A
  1. Hyperechoic, nonshadowing, and nonmobile mass that projects from the gallbladder wall into the gallbladder lumen
44
Q

Clinical findings of polyps

A

Asymptomatic

45
Q

Gallbladder polyps are often seen with _______ that results from the disturbance in cholesterol metabolism and accumulation of cholesterol

A

Cholesterolosis

46
Q

The gallbladder should not exceed ________ in width and _______ in length

A

•4 to 5cm
•8 to 10cm

47
Q

Sources of focal gallbladder wall thickening (4):

A

•gallbladder polyp
•adenomyomatosis
•gallbladder carcinoma
•adhered gallstone

48
Q

_____ is hourglass appearance of the gallbladder

A

Bilobed gallbladder

49
Q

Gallbladder fundus is folded into itself

A

Phrygian cap

50
Q

Outpouching of the gallbladder neck

A

Hartmann pouch

51
Q

Blood supply to the gallbladder is via the

A

Cystic artery

52
Q

_____ is thick and mimics an intraluminal gallbladder mass

A

Tumefactive sludge

53
Q

______ is thought to be caused by chronic irritation of the gallbladder wall by gallstones

A

Gallbladder carcinoma

54
Q

The most common metastatic disease of the gallbladder is

A

Malignant melanoma

55
Q

Sources of diffused gallbladder wall thickening (8):

A
  1. Gallbladder carcinoma
  2. Hypoalbuminemia
  3. AIDS cholangiopathy
  4. Congestive heart failure
  5. Postprandial
  6. Cholecystitis
  7. Adenomyomatosis
  8. Hepatic dysfunction
56
Q

The portion of the biliary tree that lies distal to the Union of the cystic duct with the hepatic duct is the:

A

Common bile duct

57
Q

A gallbladder sonogram should be performed after the patient had had nothing to eat for _____

A

4 to 8 hours

58
Q

Gallstones typically consist of a mixture of

A

•cholesterol
•calcium
•bilirubinate
•calcium carbonate

59
Q

What are the six F’s for gallstones

A

•fat
•female
•fertile
•flatulent
•fair
•fourty

60
Q

A gallbladder that is completely filled with gallstones May exhibit the

A

Wall-echo-shadow sign (WES)

61
Q

_______, within the gallbladder is most often associated with biliary stasis

A

Sludge (viscid bile)

62
Q

_______ may also form into sludge balls, which are typically mobile and will now produce an acoustic shadow

A

Tumefactive sludge

63
Q

The gallbladder can also completely fill with Tumefactive sludge, causing the gallbladder to appear:

A

Isoechoic to the liver tissue (hepatization of the gallbladder)

64
Q

Clinical findings of gallbladder sludge (2):

A
  1. Asymptomatic
  2. Any reasons for biliary stasis (sludge)
65
Q

Sonographic findings of gallbladder sludge (1):

A
  1. Low-level nonshadowing, echoes
66
Q

If a thrombus completely occludes the portal vein, what will happen?

A

Collaterals within the portal vein region

67
Q

Calcifications of the gallbladder wall is termed

A

Porcelain gallbladder

68
Q

_____ is associated with courvoisier gallbladder

A

Pancreatic head mass

69
Q

The spiral valves of heister are found within the:

A

Cystic duct

70
Q

Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with:

A

Adenomyomatosis

71
Q

Diabetic patients suffering from acute cholecystitis have an increased risk for developing

A

Emphysematous cholecystitis

72
Q

Focal tenderness over the gallbladder with probe pressure describes:

A

Murphy sign

73
Q

Sonographic findings of porcelain gallbladder (2):

A
  1. Calcifications of the gallbladder wall with shadowing
  2. Chronic cholecystitis may be present
74
Q

Sonographic findings of gallbladder enlargement (2):

A
  1. Measures more than 4-5cm in diameter or more than 8-10cm in length
  2. Search for obstruction
75
Q

____ is a form of acute cholecystitis and is more commonly found in children, recently hospitalized patients, or immunocompromised

A

Acalculous cholecystitis

76
Q

Clinical findings of acalculous cholecystitis (3):

A
  1. RUQ tenderness
  2. Pain
  3. Leukocytosis
77
Q

____ results from the intermittent obstruction of the cystic duct by gallstones, resulting in multiple bouts of acute cholecystitis

A

Chronic cholecystitis

78
Q

Gas bubbles within the gallbladder wall that may rise to the nondependent wall of the gallbladder is known as

A

Champagne sign

79
Q

______is a form of acute cholecystitis that is caused by gas forming infection invading the gallbladder lumen, wall, or both

A

Emphysematous cholecystitis

80
Q

With adenomyomatosis, the liminal epithelium is hyperplastic and the muscular layer becomes thickened producing:

A

tiny pockets called Rokitansky-Aschoff sinuses

81
Q

Adenomyomatosis is literally interrupted as

A

The condition of glands within the muscle of the gallbladder

82
Q

Clinical findings of Adenomyomatosis

A

•asymptomatic

83
Q

Clinical findings of porcelain gallbladder

A

•asymptomatic

84
Q

Sonographic findings of gallbladder carcinoma(4):

A
  1. Nonmobile mass that measures more than 1cm
  2. Wall thickening
  3. Irregular mass
  4. Mass invasion into surrounding tissue
85
Q

Clinical findings of gallbladder carcinoma (6):

A
  1. Weightloss
  2. Pain
  3. Jaundice
  4. Nausea and vomiting
  5. Hepatomegaly
  6. Possible elevation in ALP, ALT, GGT and bilirubin
86
Q

Clinical findings of cholelitiasis (6):

A
  1. Asymptomatic
  2. Biliary colic (onset pain)
  3. Abdominal pain after fatty meals
  4. Nausea and vomiting
  5. Pain that radiates to the shoulders
87
Q

Sonographic findings of adenomyomatosis (2):

A
  1. Focal or diffuse thickening of the gallbladder wall
  2. Comet tail artifact that projects from the gallbladder wall into the lumen of the gallbladder
88
Q

Clinical findings of acute cholecystitis

A

•RUQ tenderness
• pain
•luekocytosis
•elevation in ALP,ALT, GGT and bilirubin
•pain that radiates to the shoulders
•nausea and vomiting

89
Q

Sonographic findings of acute cholecystitis (6):

A
  1. Gallstones
  2. Murphy sign
  3. Gb wall thickening
  4. Gb enlargement
  5. Pericholecystic fluid
  6. Sludge
90
Q

Sonographic findings of emphysematous cholecystitis (2):

A
  1. Dirty shadowing, reverberation, or ring down artifact
  2. Champagne sign
91
Q

Clinical findings of emphysematous cholecystitis (4):

A
  1. Diabetic or immunosuppressive pt
  2. Pain
  3. Fever
  4. Sepsis
92
Q

Sonographic findings of chronic cholecystitis (4):

A
  1. Contracted gallbladder
  2. WES sign
  3. Gallstones
  4. Wall thickening
93
Q

Clinical findings of chronic cholecystitis (2):

A
  1. Intolerance too fatty foods because of subsequent abdominal pain
  2. Nontender gallbladder
94
Q

Clinical findings of gallbladder enlargement (3):

A
  1. Palpable gallbladder
  2. Painless jaundice
  3. Possible elevation in ALP, ALT, GGT, and bilirubin
95
Q

Sonographic findings of Acalculous choleystitis(4):

A
  1. Murphy sign
  2. Gallbladder wall thickening
  3. Pericholecystic fluid
  4. No stones

ARRT (Abdominal US) (14 decks)

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