Exam 3 - Gallbladder Diseases Flashcards
cholelithiasis
- stones in the gallbladder
- impaired metabolism of cholesterol, bilirubin, and bile acids
risk factors for cholelithiasis
- obestity
- sex (female)
- middle ages
- use of oral contraception
- rapid weight loss
- indigenous American ethnicity
- genetic predisposition
- pancreatic or ileal disease
three types of cholelithiasis stones
- cholesterol
- pigmented
- mixed
cholelithiasis manifestations
- usually asymptomatic
- epigastric and right quadrant pain
- intolerance to fatty foods
- biliary colic
- jaundice
symptoms cholelithiasis
- heartburn
- flatulence
- epigastric
- discomfort
- food intolerances (fats and cabbage)
biliary colic
occurs 30 minutes to several hours after eating fatty meal
what does severity of cholelithiasis depend on
- movement of stones
- obstruction
jaundice
- bile cannot flow into duodenum
dark amber urine that foams when shaken
soluble bilirubin in urine
clay colored stools
bilirubin does not reach small intestine to be converted into urobilinogen
steatorrhea
no bile salts in duodenum, preventing fat digestion
pruritis
deposit of bile salts into skin tissues
intolerance to fatty foods
no bile in small intestine to help with fat digestion
bleeding tendencies
decreased absorption of vitamin K
cholecystitis
- acute or chronic
- caused by a gallstone lodged in the cystic duct
- leads to distended and inflamed gallbladder
what does pressure against distended wall of the gallbladder lead to
- decreased blood flow
- ischemia
- necrosis
- perforation
what is common to see with cholecystitis
- fever
- leukocytosis
- rebound tenderness
- guarding
lab values for cholecystitis
- increased bilirubin and alk phos
analgesic - ketorolac
pain control
antiemetics
nausea and vomiting
anticholinergics
decrease gallbladder secretion and stop smooth muscle spasms
bile acids
- (rarely used)
- dissolve stones
