cholecystits. cholelitheiasis & gall stones Flashcards
What is acute cholecystitis?
Inflammation of the gallbladder
What is the main cause of acute cholecystiti?
Gallstones
Where do gallstones get stuck?
In the cystic duct obstruction
What accounts for 90% of acute cholecystitis
Gall stones
What is cause of acute cholecystitis in South Asia, Latin America and Africa
Helminths infection
What causes irritation and as a result increased pressure
Bile getting trapped in the gallbladder
What kind of pain does a patient with acute cholecystitis complain of?
Severe RUQ pain
Where does pain get referred to in a patient with acute cholecystitis?
Shoulder
When will patient feel worse pain suffering from acute cholecystitis
After eating greasy heavy meal
What other symptoms does patient with acute cholecystitis suffer from?
RUQ pain Vomiting Nausea Fever Tenderness
What positive sign would you expects today see in a patient with acute cholecystitis
Positive Murphy sign
What is the main difference between biliary colic and acute cholecystitis
Inflammatory component e.g. fever, peritonitis and increased weight cell count
What blood results would you expect from a patient with acute cholecystitis
Leukocytosis
Abnormal LFT
What imaging technique could be used to visualise gallstones in acute cholecystitis
Ultrasound
What treatment for acute Cholecystitis
Pain relief
IV antibiotics
Does acute cholecystitis present with jaundice
No
What are 3 complications of acute cholecystitis
Chronic cholecystitis
mucocele
Emyphema
What does cholelithieiasis refer to?
formation of gallstones
What is the function of bile?
emulsifies fat and makes it easier to break down so it can be easily absorbed
what is bile made up of?
cholesterol
bilirubin
calcium salts
What does an imbalance in the mixture of bilirubin cause?
formation of gallstones
how many different types of gallstones are there?
2 types
what are the different types of gallstones that can be formed
Cholesterol gallstones
pigmented gallstones:
1. black
2. brown
which tyoe of gallstone accounts up to 80% of gallstones
cholesterol gallstones
what are the reasons for cholesterol gallstone formation?
excess cholesterol
relative deficiency of bile salts and phospholipids
what would a black pigmented gall stone indiciated?
haemolysis
what would a brown pigmented gallstone indicate?
infection
What do pigmented stones consist of?
excess billirubin and calcium billirubinate
give an example of a condition that may present with black pigmented gallstones
sickle cell anaemia
what are the 5 risk factors for gallstone formation?
fat female 40 family history fertile
give other causes of gallstone formation other than the 5 F’s
older age
obesity
pregnancy
rapid weight loss
why can being overweight/obese increase risk of developing gallstones
high levels of cholesterol in bile
why does being female increase risk of gallstone formation (2 reasons)
- progesterone reduces gallbladder contractibility = increased retention of bile
- oestrogen increases stone formation
what type of contraception taken by women can increase chances of developing gallstones?
oral contraceptive pills
why can recent rapid weight loss increases chances of developing gallstones
prevents gall bladder from emptying properly
give an example of a medication that can increase gallstone formation?
antibiotics e.g. ceftriaxone
what is a biloary colic?
pain associated with obstruction of the cystic duct
when might a patient have worsen RUQ pain?
after eating
why does eating cause worsen RUQ pain in gallstone formation?
eating causes the gallbladder to contract in trying to release bile
