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ABDOMEN REGISTRY > Chapter 3: Gallbladder > Flashcards

Chapter 3: Gallbladder Flashcards

1
Q

The gallbladder is located posterior to which lobe of the liver

A

The right lobe

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2
Q

Name the three layers of the gallbladder wall from innermost to outermost

A

Mucosal, fibromuscular, serosal

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3
Q

What connects the gallbladder to the rest of the biliary system

A

The cystic duct

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4
Q

What is the most common location for stones and why

A

The fundus, because is the most dependent part

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5
Q

What hormone causes gallbladder contraction

A

Cholecystokinin

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6
Q

The _____ artery is a small branch of the right hepatic artery, and supplies blood to the gallbladder

A

Cystic artery

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7
Q

What does a bilobed gallbladder (normal variant) looks like

A

Like an hourglass

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8
Q

The Phrygian cap is the most common gallbladder variant. Describe it

A

The fundus is folded

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9
Q

Describe the septate gallbladder variant

A

Thin separations within gallbladder

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10
Q

What is the Hartman pouch variant

A

Outpouching of gallbladder neck

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11
Q

What is the junctional fold variant

A

Fold at the neck junction

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12
Q

A floating gallbladder can twist off the blood supply and this is called

A

Gallbladder torsion or gallbladder vulvulus

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13
Q

Which type of gallbladder is totally surrounded by liver

A

Intrahepatic gallbladder

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14
Q

The gallbladder holds about ___ ml of bile

A

40

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15
Q

The normal length of the gallbladder is between ____ and ____ cm

A

8-10

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16
Q

The normal diameter of the gallbladder should be

A

4-5 cm

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17
Q

The gallbladder wall should measure

A

3mm

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18
Q

Describe Cholelithiasis

A

Stones within gallbladder lumen

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19
Q

What are the symptoms of cholelithiasis

A

(Can be asymptomatic)
Biliary colic, pain after meals, nausea and vomiting, pain that radiates to shoulders

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20
Q

Stones typically consist of a mixture of what

A

Cholesterol, calcium, bilirubinate, and calcium carbonate

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21
Q

Cholelithiasis is most commonly seen in _____ patients

A

Female

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22
Q

What are some risk factors that can lead to Cholelithiasis

A

Obesity, pregnancy, increased parity, gestational diabetes, estrogen use, Crohn disease, total parenteral nutrition, rapid weight loss

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23
Q

Sludge is most often associated with biliary _____

A

Stasis

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24
Q

What are the symptoms of sludge

A

Asymptomatic

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25
Q

What is tumefactive sludge

A

Thick sludge that looks like a mass. Make sure it moves to rule out a mass

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26
Q

What is hepatization of the gallbladder referred to

A

When the gallbladder is completely filled with tumefactive sludge, it looks isoechoic to the liver

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27
Q

What are the symptoms of gallbladder polyps

A

Asymptomatic

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28
Q

______ polyps are the most common type

A

Cholesterol

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29
Q

Polyps tend to measure less than ____ mm

A

10

30
Q

Large polyps or fast growing ones are concerning for

A

Carcinoma

31
Q

Polyps are often seen with cholesterolosis, which is

A

Build up cholesterol in wall

32
Q

What is hyperplastic cholecytosis

A

A group of proliferative and degenerative gallbladder disorders

33
Q

Hyperplastic cholecytosis includes what two disorders

A

Adenomyomatosis and cholesterolosis

34
Q

What is a strawberry gallbladder

A

Diffuse polyploid appearance of the gallbladder

35
Q

What is adenomyomatosis

A

When the muscular layer of the gallbladder becomes thickened

36
Q

When the muscular layer of the GB is thickened (adenomyomatosis) what does this produce

A

Tiny pockets called Rokitansky Aschoff sinuses

37
Q

What are the symptoms of adenomyomatosis

A

Asymptomatic

38
Q

Adenomyomatosis will produce what artifact

A

Comet tail

39
Q

What is emphysematous cholecystitis

A

Form of acute cholecystitis caused by gas forming infection

40
Q

What are the Sonographic findings of emphysematous cholecystitis

A

Dirty shadowing reverberation or ring down artifact

41
Q

What are the clinical findings of emphysematous cholecystitis

A

RUQ pain (negative Murphy sign)
Fever
Diabetic patient

42
Q

Emphysematous cholecystitis can become into _____

A

Sepsis

43
Q

What is acute cholecystitis

A

Sudden onset of gallbladder inflammation. Commonly caused by a stone stuck in the neck or cystic duct

44
Q

What are the symptoms of acute cholecystitis

A

RUQ tenderness with positive Murphy sign
Nausea and vomiting
Fever
Pain that radiates to shoulder
Jaundice (if there’s an obstruction)

45
Q

What lab values are expected to be elevated when acute cholecystitis is present

A

WBCs
Bilirubin (with obstruction)
ALP, ALT, GGT

46
Q

What are the sonographic findings of acute cholecystitis

A

Gallstones, wall thickening, enlargement of gallbladder, pericholecystic fluid, and sludge

47
Q

What is a gangrenous cholecystitis

A

A direct evolution of acute cholecystitis

48
Q

What are the sono findings of gangrenous cholecystitis (in addition to those of acute cholecystitis)

A

Focal wall necrosis
Bulges of the wall
Sloughed membranes
Ulcerative craters

49
Q

Perforation of the GB has a high mortality rate. Would the pt demonstrate a positive Murphy sign with this finding

A

No

50
Q

Chronic cholecystitis results from the intermittent ________ of cystic ducts by stones

A

Obstruction

51
Q

Patients with chronic cholecystitis will have what symptoms

A

Intolerance to fatty foods and nontender gallbladder

52
Q

What lab values may be elevated with chronic cholecystitis

A

ALP, AST, and ALT

53
Q

What are the sono findings of chronic cholecystitis

A

Thickened wall, stones, WES sign, contracted GB

54
Q

Acalculus cholecystitis presents with all symptoms and findings of _________, except no stones are present

A

Cholecystitis

55
Q

What is empyema/ suppurative cholecystitis

A

When the gallbladder is filled with pus.
It will appear echogenic

56
Q

Xanthogranulomatous cholecystitis results from chronic infection in GB, what are the findings related to this

A

Intramural accumulation of inflammatory cells (echogenic debris)
Asymmetrical thickening of wall

57
Q

An enlarged gallbladder is also called

A

Hydropic gallbladder

58
Q

An enlarged gallbladder can be caused by a blockage of the _____ duct, or other parts of the biliary tree

A

Cystic

59
Q

What are the symptoms of an enlarged gallbladder

A

Maybe asymptomatic. Pts can have epigastric pain, nausea or vomiting

60
Q

What is a Courvoisier gallbladder

A

Enlarged, palpable gallbladder caused by a pancreatic head mass

61
Q

Gallbladder hydrops in infants can be associated with what disease

A

Kawasaki disease

62
Q

What are the symptoms of a porcelain gallbladder

A

Asymptomatic

63
Q

What is porcelain gallbladder

A

Calcification of gallbladder wall

64
Q

Xray or CT is often used to confirm the diagnosis of ______ GB

A

Porcelain

65
Q

______ carcinoma is the most common cancer of the biliary tract, even though is rare

A

Gallbladder

66
Q

Gallbladder carcinoma is caused by chronic irritation of the wall by_____

A

Stones

67
Q

Pts who suffer from chronic cholecystitis have an increased risk of developing _______

A

Gallbladder carcinoma

68
Q

What are the symptoms of gallbladder carcinoma

A

Asymptomatic at first.
Then, nausea, vomiting, weight loss, RUQ pain, jaundice and hepatomegaly

69
Q

What does gallbladder carcinoma look like on ultrasound

A

Nonmobile hypoechoic mass in the lumen, or as diffuse wall thickening. May contain stones

70
Q

Gallbladder carcinoma is suspected if there’s a mass or polyp measuring more than ___cm

A

1

71
Q

What is the gold standard imaging for gallbladder

A

Ultrasound

ABDOMEN REGISTRY (13 decks)

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