Diseases of the GB 2 Flashcards
What major parasite is known to cause ascending cholangitis?
clonorchis sinensis
What are some drug induced causes of cholestasis?
phenothiazines
oral contraceptives
methyltestosterone
cimetidine
erythromycin
What are Kupffer cells?
specialized macrophage cells that assist in preventing bacteria from entering the biliary system
What does MRCP stand for?
magnetic resonance cholangiopancreatography
What is the gold standard test for biliary obstruction?
ERCP
Treatment of ascending cholangitis?
IV antibiotics, analgesics, antiemetics and IV fluids
Obstructing stones that are too large to be removed or broken mechanically by ERCP may be managed how?
extracorporeal shock wave lithotripsy
What does ESWL stand for?
extracorporeal shockwave lithotripsy
ESWL can be used concomitantly with what type of dissolution therapy?
ursodeoxycholic acid
Oral dissolution of cholesterol gallstones with ursoeoxycholic acid is great for what type of patients?
an option for patients who are not operative candidates for cholecystectomy
What are some severe complications of cholangitis?
kidney failure
respiratory failure
wound infection
pneumonia
How is porcelain gallbladder caused?
calcification of the gallbladder believed to be brought on by excessive gallstones exact cause not clear
What is the recommended treatment for porcelain gallbladder?
cholecystectomy
Why is the recommended treatment for porcelain gallbladder a cholecystectomy?
because of the increased risk for gallbladder cancer
Prognosis of gallbladder carcinoma (adenocarcinoma of the gallbladder)?
poor
What are signs and symptoms of gallbladder cancer?
steady pain in the upper right abdomen
dyspepsia (gas)
jaundice and vomiting due to obstruction
What are important risk factors to remember in someone having GB cancer?
Gender - twice as common in women than men, usually in seventh and eighth decades
Obesity
Chronic typhoid infection of gallbladder; chronic Salmonella typhi carriers have 3 to 200 times higher risk of gallbladder cancer than non-carriers and 1–6% lifetime risk of development of cancer
What is the only way to tell whether or not a tumor has grown malignant?
a biopsy
What are the most common locations for spread of gallbladder adenocarcinoma?
liver, bile duct, stomach, and duodenum
