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Abdomen Board Review > Chapter 4: The Bile Ducts > Flashcards

Chapter 4: The Bile Ducts Flashcards

1
Q

inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ

A

acute pancreatitis

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2
Q

the merging point of the pancreatic duct and common bile duct just before the sphincter of Oddi; also referred to as the hepatopancreatic ampulla

A

ampulla of Vater

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3
Q

a conjenital disease described as the narrowing or obliteration of all or a portion of the biliary tree

A

biliary atresia

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4
Q

a condition in which bile is stagnant and allowed to develop into sludge or stones

A

biliary stasis

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5
Q

a congenital disorder characterized by segmental dilatation of the intrahepatic ducts

A

Caroli disease

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6
Q

primary bile duct cancer

A

cholangiocarcinoma

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7
Q

inflammation of the bile ducts

A

cholangitis

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8
Q

the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis, scarring, and the development of calcification within the gland

A

chronic pancreatitis

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9
Q

a malignant biliary tumor located at the junction of the right and left hepatic ducts

A

Klatskin tumor

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10
Q

a clinical condition when the patient presents with jaundice, pain, and fever, secondary to a lodged stone in the cystic duct causing compression of the common hepatic duct

A

Mirizzi syndrome

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11
Q

the area of the liver where the portal vein and hepatic artery enter and the hepatic ducts exit; also referred to as the liver hilum

A

porta hepatis

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12
Q

the muscle that controls the emptying of bile and pancreatic juices into the duodenum; also referred to as the hepatopancreatic sphincter

A

sphincter of Oddi

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13
Q

folds located within the cystic duct that prevent it from collapsing and distending

A

spiral valves of Heister

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14
Q

contents of a portal triad

A

small branches of hepatic artery, portal vein, and intrahepatic duct

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15
Q

normal diameter of the common duct in adults at the level of the porta hepatis

A

between 1 and 7 mm

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16
Q

maximum diameter of the bile duct that is considered normal if the patient is over 60 or has had a cholecystectomy

A

10 mm

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17
Q

what are the structures in the “shotgun sign”?

A

common bile duct and adjacent portal vein

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18
Q

biliary dilatation will occur ________ to the level of obstruction

A

proximal

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19
Q

3 parts of the biliary tree that are considered extrahepatic

A

common bile duct
cystic duct
part of the common hepatic duct

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20
Q

most common level for an obstruction to occur in the biliary tree

A

distal common bile duct

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21
Q

most common cause of obstructive jaundice

A

gallstones located within the common bile duct

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22
Q 
Clinical findings:
jaundice
elevated bilirubin
elevated alkaline phosphatase
RUQ pain
A

choledocholithiasis

23
Q

Sonographic findings:
echogenic foci within the bile duct that may or may not shadow
may have biliary dilatation but not always

A

choledocholithiasis

24
Q

cholangitis should be suspected when the bile ducts walls exceed:

A

5 mm

25
Q 
Clinical findings:
fever
leukocytosis
jaundice
RUQ pain
elevated alkaline phosphatase
elevated bilirubin
A

cholangitis

26
Q 
Sonographic findings:
biliary dilatation
biliary sludge
choledocholithiasis
bile duct wall thickening
A

cholangitis

27
Q

Clinical findings:
recent biliary surgery
symptoms of acute cholecystitis

A

pneumobilia

28
Q

Sonographic findings:

echogenic linear structures within the ducts that produce ring-down artifacts and may have dirty shadowing

A

pneumobilia

29
Q

most common manifestation of cholangiocarcinoma

A

Klatskin tumors

30
Q

dilated intrahepatic ducts that abruptly terminate at the level of the tumor are suggestive of:

A

cholangiocarcinoma

31
Q 
Clinical findings:
jaundice
pruritus
unexplained weight loss
abdominal pain
elevated bilirubin
elevated alkaline phosphatase
A

cholangiocarcinoma

32
Q

Sonographic findings:
dilated intrahepatic ducts that abruptly terminate at the level of the tumor
a solid mass may be noted within the liver or ducts

A

cholangiocarcinoma

33
Q

Sonographic findings:
absent biliary ducts
cirrhosis and portal hypertension findings

A

biliary atresia

34
Q

most common type of choledochal cyst

A

cystic dilatation of the common bile duct

35
Q

Clinical findings: (pediatric patient)
jaundice
pain
fever

A

choledochal cyst

36
Q

Sonographic findings: (pediatric patient)
cystic mass in the area of the porta hepatis (separate from the gallbladder)
biliary dilatation

A

choledochal cyst

37
Q

Sonographic findings: (pediatric patient)
segmental dilatation of the intrahepatic ducts
patient may also have cystic renal disease

A

Caroli disease

38
Q 
The merging point of the pancreatic duct and common bile duct at the level of the duodenum is referred to as the:
A. sphincter of Oddi
B. ampulla of Vater
C. common bile duct
D. cystic duct
A

ampulla of Vater

39
Q

The Klatskin tumor is located:
A. at the junction of the right and left hepatic ducts
B. at the junction of the cystic and common bile ducts
C. at the junction of the common bile duct and common hepatic duct
D. between the pancreatic head and duodenum

A

at the junction of the right and left hepatic ducts

40
Q 
A patient presents with jaundice, pain, and fever, secondary to an impacted stone in the cystic duct. This is referred to as:
A. Caroli syndrome
B. Mirizzi sundrome
C. choledochal cysts
D. biliary atresia
A

Mirizzi syndrome

41
Q 
The spiral valves of Heister are located within the:
A. common bile duct
B. pancreatic duct
C. common hepatic duct
D. cystic duct
A

cystic duct

42
Q 
If a gallstone, causing obstruction, is located within the distal common hepatic duct, which of the following would become dilated?
A. common bile duct only
B. gallbladder only
C. intrahepatic ducts
D. all of the above
A

intrahepatic ducts

43
Q 
Which of the following is considered the most proximal portion of the biliary tree?
A. intrahepatic radicles
B. cystic duct
C. common hepatic duct
D. common bile duct
A

intrahepatic radicles

44
Q 
Which of the following would be the most distal portion of the biliary tree?
A. common bile duct
B. common hepatic duct
C. gallbladder
D. intrahepatic radicles
A

common bile duct

45
Q 
If an obstructive biliary calculus is located within the distal common duct, which of the following could ultimately dilate?
A. common bile duct
B. gallbladder
C. common hepatic duct
D. all of the above
A

all of the above

46
Q 
The gallbladder is connected to the biliary tree by the:
A. cystic duct
B. ampulla of Vater
C. sphincter of Oddi
D. common bile duct
A

cystic duct

47
Q 
A 64-year-old man presents to the sonography department for a RUQ sonogram. He is complaining of abdominal pain, weight loss, and pruritus. Sonographically, you visualize an area of dilated ducts that abruptly end. What is the most likely diagnosis?
A. biliary atresia
B. choledocholithiasis
C. Caroli syndrome
D. cholangiocarcinoma
A

cholangiocarcinoma

48
Q 
All of the following are clinical findings consistent with cholangiocarcinoma except:
A. pruritus
B. weight loss
C. elevated bilirubin
D. dilation of the intrahepatic ducts
A

dilation of the intrahepatic ducts

49
Q 
Which of the following is not associated with the development of pneumobilia?
A. cholangiopneumonia
B. gastric surgery
C. acute cholecystitis
D. fistula formation
A

cholangiopneumonia

50
Q 
The biliary duct wall should never measure more than:
A. 2 mm
B. 9 mm
C. 4 mm
D. 5 mm
A

5 mm

51
Q 
Clinical findings of choledocholithiasis include all of the following except:
A. jaundice
B. elevated bilirubin
C. elevated blood urea nitrogen
D. elevated alkaline phosphatase
A

elevated blood urea nitrogen

52
Q

Which segment of the biliary tree tends to dilate first with obstruction?
A. intrahepatic
B. extrahepatic

A

extrahepatic

53
Q 
Which of the following is not a plausible cause of common bile duct obstruction in adults?
A. choledocholithiasis
B. chronic pancreatitis
C. choledochal cyst
D. pancreatic carcinoma
A

choledochal cyst

54
Q 
All of the following are forms of cholangitis except:
A. acute bacterial
B. AIDS
C. oriental
D. parabolic
A

parabolic

Abdomen Board Review (14 decks)

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