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Theory Test 6 > Cholelithiasis > Flashcards

Cholelithiasis Flashcards

1
Q

Cholecystitis

A
  • inflammation of gallbladder- assoc w obstr. From stones or biliary sludge
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2
Q

Cholelithiasis

A

gallbladder stones from bile salts, cholesterol, Ca+

Can remain in gallbladder or migrate to common bile duct, cystic duct

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3
Q

Population for Cholelithiasis

A

Higher in white, multiparous women over 40.

High incidence in Navaho + pima.

Related to sedentary lifestyle/genetic/obesity

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4
Q

Clinical Manifestations of Cholelithiasis

A

Can be silent, severity depends on stones/obstruction
Restlessness,
diaphoresis,
NV

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5
Q

Physical Manifestations of Cholelithiasis

A

Indigestion/pain in RUQ, deferred to R shoulder/scapula.

Adb rigidity

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6
Q

Biliary Colic

A

spasm 2nd to movt of stones or obstr. Severe pain for 1 hr. tachy.sweat. Residual RUQ tenderness Pain 3-6 hrs after heavy meal or when laying down

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7
Q

Total Biliary Obstruction

A
  • Dark amber urine, clay stools

(steatorrhea) - pruritus, jaundice, bleeding

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8
Q

Labs associated with Cholelithiasis

A

CBC (inflammation) Bilirubin (obstruct)

Alkaline phosphatase-ALT/AST. Amylase (pancreas involved)

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9
Q

Pain control for cholelithiasis

A

Analgesics: Ketorolac

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10
Q

Non surgical treatment for cholelithiasis

A

Fluid replacement, anticholinergic (atropine) antibiotics, diet, ercp, surgery, lithotripsy

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11
Q

Surgical treatment for cholelithiasis

A

Cholecystectomy- incision

o Choledocholithotomy

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12
Q

Choledocholithotomy

A

– incision in common bile duct to remove stone

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13
Q

Post op treatment for Choledocholithotomy

A

respp., cough/deep breath,
early abulation,
antiemetics,
NPO (NG tube for decompression)

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14
Q

Cirrhosis

A

chronic progressive disease- breakdown of hepatocytes, leads to scar tissue

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15
Q

Types of cirrhosis

A

EtoH/portal/nutritional- most common, related to nutrition

Biliary causes- primary biliary cirrhosis/primary sclerosing cholangitis

Cardiac- chronic rhf

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16
Q

Early clinical manifestations of cirrhosis

A 
Anorexia, 
dyspepsia, 
flatulence, 
nausea, 
vomiting, 
change in bowel habits

Abd pain – dull, heaviness in RUQ or epigastrium,
Fever,
slight weight loss,
enlargement of liver & spleen

17
Q

Late clinical manifestations of cirrhosis

A

gradual-
Jaundice,
peripheral edema,
ascites,

Skin lesions:
spider angiomas,
Hematologic/Endocrine problems, Peripheral neuropathy

18
Q

Labs for cirrhosis

A 
Liver enzyme levels (AST, ALT, GGT)  
Serum pH,  
Creatinine, 
 Protein; albumin & prealbumin levels  
Coag. Studies (PT)  
Electrolytes  
Hgb & Hct  BUN  
Stools for occult blood
19
Q

Procedure for cirrhosis

A

Paracentesis to manage ascites

Theory Test 6 (6 decks)

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