cholecystits. cholelitheiasis & gall stones

Question 1

What is acute cholecystitis?

Answer 1

Inflammation of the gallbladder

Question 2

What is the main cause of acute cholecystiti?

Answer 2

Gallstones

Question 3

Where do gallstones get stuck?

Answer 3

In the cystic duct obstruction

Question 4

What accounts for 90% of acute cholecystitis

Answer 4

Gall stones

Question 5

What is cause of acute cholecystitis in South Asia, Latin America and Africa

Answer 5

Helminths infection

Question 6

What causes irritation and as a result increased pressure

Answer 6

Bile getting trapped in the gallbladder

Question 7

What kind of pain does a patient with acute cholecystitis complain of?

Answer 7

Severe RUQ pain

Question 8

Where does pain get referred to in a patient with acute cholecystitis?

Answer 8

Shoulder

Question 9

When will patient feel worse pain suffering from acute cholecystitis

Answer 9

After eating greasy heavy meal

Question 10

What other symptoms does patient with acute cholecystitis suffer from?

Answer 10

RUQ pain 
Vomiting 
Nausea 
Fever 
Tenderness

Question 11

What positive sign would you expects today see in a patient with acute cholecystitis

Answer 11

Positive Murphy sign

Question 12

What is the main difference between biliary colic and acute cholecystitis

Answer 12

Inflammatory component e.g. fever, peritonitis and increased weight cell count

Question 13

What blood results would you expect from a patient with acute cholecystitis

Answer 13

Leukocytosis

Abnormal LFT

Question 14

What imaging technique could be used to visualise gallstones in acute cholecystitis

Answer 14

Ultrasound

Question 15

What treatment for acute Cholecystitis

Answer 15

Pain relief

IV antibiotics

Question 16

Does acute cholecystitis present with jaundice

Answer 16

No

Question 17

What are 3 complications of acute cholecystitis

Answer 17

Chronic cholecystitis
mucocele
Emyphema

Question 18

What does cholelithieiasis refer to?

Answer 18

formation of gallstones

Question 19

What is the function of bile?

Answer 19

emulsifies fat and makes it easier to break down so it can be easily absorbed

Question 20

what is bile made up of?

Answer 20

cholesterol
bilirubin
calcium salts

Question 21

What does an imbalance in the mixture of bilirubin cause?

Answer 21

formation of gallstones

Question 22

how many different types of gallstones are there?

Answer 22

2 types

Question 23

what are the different types of gallstones that can be formed

Answer 23

Cholesterol gallstones
pigmented gallstones:
1. black
2. brown

Question 24

which tyoe of gallstone accounts up to 80% of gallstones

Answer 24

cholesterol gallstones

Question 25

what are the reasons for cholesterol gallstone formation?

Answer 25

excess cholesterol | relative deficiency of bile salts and phospholipids

Question 26

what would a black pigmented gall stone indiciated?

Answer 26

haemolysis

Question 27

what would a brown pigmented gallstone indicate?

Answer 27

infection

Question 28

What do pigmented stones consist of?

Answer 28

excess billirubin and calcium billirubinate

Question 29

give an example of a condition that may present with black pigmented gallstones

Answer 29

sickle cell anaemia

Question 30

what are the 5 risk factors for gallstone formation?

Answer 30

``` fat female 40 family history fertile ```

Question 31

give other causes of gallstone formation other than the 5 F's

Answer 31

older age obesity pregnancy rapid weight loss

Question 32

why can being overweight/obese increase risk of developing gallstones

Answer 32

high levels of cholesterol in bile

Question 33

why does being female increase risk of gallstone formation (2 reasons)

Answer 33

1. progesterone reduces gallbladder contractibility = increased retention of bile 2. oestrogen increases stone formation

Question 34

what type of contraception taken by women can increase chances of developing gallstones?

Answer 34

oral contraceptive pills

Question 35

why can recent rapid weight loss increases chances of developing gallstones

Answer 35

prevents gall bladder from emptying properly

Question 36

give an example of a medication that can increase gallstone formation?

Answer 36

antibiotics e.g. ceftriaxone

Question 37

what is a biloary colic?

Answer 37

pain associated with obstruction of the cystic duct

Question 38

when might a patient have worsen RUQ pain?

Answer 38

after eating

Question 39

why does eating cause worsen RUQ pain in gallstone formation?

Answer 39

eating causes the gallbladder to contract in trying to release bile