Chapter 44: Biliary Disorders

Question 1

Bile is made in the _______ and is stored in the ___________

Answer 1

liver
gallbladder

Question 2

Bile helps with digestion and absorption of _______

Answer 2

fats

Question 3

Cholelithiasis is _________ in the gallbladder

Answer 3

stones

Question 4

Cholecystitis is the ____________ of the gallbladder, which may be either acute or chronic

Answer 4

inflammation

Question 5

Choledocholithiasis is stones in the ________ _____ ______ that can lead to backup of bile into the gallbladder and liver

Answer 5

common bile duct

Question 6

In cholecystitis, 90% of cases are caused by a ____________ obstructing bile outflow

Answer 6

gallstone

Question 7

Inflammation of the gallbladder is most common in those that are : (3 Fs)

Answer 7

Female
Fat
Forty

Question 8

Those with cholecystitis have an intolerance to ______ foods, severe ______ pain that radiates to the back and right shoulder, _______ urine, and ______ colored stool

Answer 8

fatty
RUQ
dark
clay

Question 9

Patients who have cholecystitis need to avoid _______ and _______ foods and need to be provide low ____, high ______, high _______ diet

Answer 9

fatty, fried
fat
carb
protein

Question 10

The 3 most common complications of cholecystitis are:

Answer 10

Gangrene — due to perforation
Infection — E. coli infiltrates from GI tract
Acalculous Cholecystitis — possible following surgeries/ trauma … results in stasis and ischemia

Question 11

Cholelithiasis is more common in those who have C___________. They are also more common in _______. Stones are made with either unconjugated pigments or with cholesterol.

Answer 11

cirrhosis
women

Question 12

Choledocholithiasis are stones located in the _________ ________ _____

Answer 12

common biliary duct

Question 13

There are two types of gallstones. One made of ____________ and the other made of ___________.

Answer 13

cholesterol
pigment

Question 14

Which type of gallstone is the most common? Cholesterol or pigment?

Answer 14

Cholesterol

Question 15

Treatment of gallstones is a procedure called :

Answer 15

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 16

For an ERCP, and endoscope is inserted into the ___________ and descends into the duodenum. A catheter is inserted into the scope that extracts the gallstones.

Answer 16

esophagus

Question 17

A cholecystectomy is the removal of the:

Answer 17

Gallbladder

Question 18

Removal of the gallbladder (cholecystectomy) is usually a laparoscopic procedure, not an open procedure (TRUE OR FALSE)

Answer 18

TRUE — usually a same day procedure done laparoscopically

Question 19

Cholecystectomy should wait until ________________ has subsided. Patients are treated first to reduce inflammation with rest, IV fluids, NG suction, analgesia, and abx

Answer 19

inflammation

Question 20

Pancreatitis is the inflammation of the ___________ = autodigestion of the ___________

Answer 20

pancreas
pancreas

Question 21

What are the two types of pancreatitis?

Answer 21

Acute and chronic

Question 22

Which type of pancreatitis is a medical emergency?

Answer 22

Acute

Question 23

Pancreatitis occurs when the pancreatic duct becomes temporarily ____________+ hypersecretion of the exocrine enzymes of the pancreas —> enzymes enter the bile duct, where they are activated with bile —> back up (reflux) into the pancreatic duct = pancreatic

Answer 23

obstructed

Question 24

Chronic pancreatitis often goes un___________ because classic clinical and diagnostic findings are not always present in the early stages of the disease. By the time symptoms occur approx. 90% of normal acinar cell function has been _______

Answer 24

detected
lost

Question 25

A _____ _____ is the initial diagnostic test that should be performed performed for patients in whole there is a suspicion of chronic pancreatitis

Answer 25

CT scan

Question 26

A ____________ ____________ tests evaluates pancreatic islet cell function and provides necessary information for making decisions about surgical resection of the pancreas

Answer 26

glucose tolerance

Question 27

It is important in chronic pancreatitis to counsel patients to avoid excessive use of _________ and __________ foods. These patients should be on a ______ carb diet, ______ protein, and ____ fat diet

Answer 27

caffeine , spicy high, low, low

Question 28

**Clinical Manifestations of chronic pancreatitis** - Pain - _______ dependency - Weight ________ - Anorexia - _____________= high fatty poop

Answer 28

Opioid loss Steatorrhea

Question 29

**Common signs and symptoms of acute pancreatitis** - Abdominal ____________ - Rigid __________ - fever - Jaundice - Nausea/Vomiting - Confusion - ________tension

Answer 29

guarding abdomen HYPO

Question 30

Pancreatic cancer is the __________ most common cancer and we don’t know why it happens

Answer 30

fourth

Question 31

Pancreatic cancer signs and symptoms are _______ at first and patients don’t know they have it until late in the disease

Answer 31

subtle

Question 32

A ________ procedure is a treatment of pancreatic cancer. This is a surgical removal of the head of the pancreas as well as a portion of thr bile duct, the gallbladder, and the duodenum. Occasionally a portion of the stomach may also be removed. After removal of these structures, the remaining pancreas, bile duct, and duodenum are sutured back into the intestine

Answer 32

Whipple