Cholecystitis pg 2233 Flashcards
without bile, fats would aggregate to form what?
hydrophobic micelles, which dont have enough surface area to allow for enzymatic digestion
what are the two main components that bile is composed of?
Bile Salts
Cholesterol and Bilirubin
what are the two major types of gallstones?
cholesterol
pigment
what are common situations that could increase the cholesterol in circulation?
estrogen, such as in pregnancy
poor diet
rapid weight loss
pigmented gallstones are formed by what?
precipitation of billirubin
what forms when the amount of cholesterol and bilirubin exceeds the amount of bile salts needed to dissolve it?
stones (precipitates) form
What are the common disease processes of gallstones?
asymptomatic cholelithiasis
biliary colic
cholecystitis
choledocholithiasis
cholangitis
what is asymptomatic cholelithiasis
condition in which a patient has glasstones present, but has not had any symptoms.
what is biliary colic?
when stones intermittently obstruct the lumen of the cystic duct
by definition, biliary colic sx last how long?
6 hours.
what is cholecystitis?
an inflammation of the gallbladder when gallstones get permanently lodged in the cystic duct.
what is choledocholithiasis?
inflammation of the gallbladder caused by obstruction of the common bile duct
what kind of lab values will you see with choledocholithiasis
increased conjugated bilirubin
what is cholangitis?
bacterial infection of the biliary duct
what is charcots Triad?
RUQ pain
fever
jaundice
with acalulous cholecystitis, typically patients will have what history?
surgery within 2-4 weeks
NPO due to some sort of critical condition
acute cholecystitis caused infections is usually what type of patients?
AIDS
what are the 6 F of cholecystitis
fat, fertile, fever, female, fart, fever.
what is the sign for cholecystitis
murphys sign.
what are the labs for cholecystitis
CBC
LFT’s
LIPASE!!!
Bilirubin
what is the gold standard for diagnosis of cholecystitis?
RUQ ultrasound
what are some complications of cholecystitis
> 24 hrs possible gallbladder necrosis.
what is the mainstay treatment of cholecystitis
cholecystectomy
what is conservative management of cholecystitis
NPO
antibiotics (etrapenem 1 g, ceftriaxone 2 g)
SEVERE: piperacillin tazobactam and metronidazole
