Gall Bladder Diseases

Question 1

Cholelithasis is

Answer 1

Stone formation within the gallbladder

Question 2

Cholelithasis symptoms

Answer 2

Colicky pain
Worse with fatty foods

Question 3

Cholelithasis diagnosis is made by

Answer 3

Right upper quadrant USS

Question 4

Cholelithasis treatment is

Answer 4

Elective Cholecystectomy

Question 5

Cholecystitis is

Answer 5

Acute inflammation of the gall bladder, a gall bladder gets stuck in the cystic duct: Cystic duct obstruction causing inflammation

Question 6

Cholecystitis symptoms include

Answer 6

positive Murphy sign
Constant pain
Fever
Leukocytosis

Question 7

What is a Murphy sign test

Answer 7

Classically, Murphy’s sign is tested for during an abdominal examination in supine position; it is performed by asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder). The patient is then instructed to breathe in. Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner’s fingers) and winces with a “catch” in breath, the test is considered positive. In order for the test to be considered positive, the same maneuver must not elicit pain when performed on the left side.

Question 8

Cholecystitis diagnosis is made by

Answer 8

RUQ USS/ CT Scan

Question 9

Cholecystitis treatment includes

Answer 9

Cholecystectomy (Semi-Urgent)

Question 10

Choledocolithasis is

Answer 10

Common bile duct obstruction with proximal inflammation

Question 11

Choledocolithasis symptoms include

Answer 11

Obstructive jaundice
Dilated hepatic bile ducts

Question 12

Choledocolithasis diagnosis is made by

Answer 12

MRCP / ERCP (MRCP is diagnostic only)

Question 13

Cholangitis is

Answer 13

Common bile duct obstruction with infection - choledocolithasis and infection, blocking flow causing a backflow of bile

Question 14

Symptoms of Cholangitis include

Answer 14

Charcots Triad
Fever
Jaundice
RUQ pain

Reynolds Pentad
Charcots Triad PLUS
Hypotension
Altered GCS

Inflammation of the entire bilary tree

Question 15

Diagnosis of Cholangitis include

Answer 15

RUQ USS , ERCP

Question 16

Treatment of Cholangitis includes

Answer 16

Emergency ERCP (can also be used for confirming diagnosis)

Question 17

Charcots Triad includes

Answer 17

FEVER
JAUNDICE
RUQ PAIN

Question 18

Reynolds Pentad includes

Answer 18

Fever
Jaundice
RUQ Pain
(Charcots triad)
PLUS
Hypotension
Altered GCS

(Reynolds pentad is a poor prognostication sign)

Question 19

What are Gallstones?

Answer 19

Gallstones consist of deposits of the constitutes of bile, most commonly cholesterol. Many small stones or one or more large stones may form but they do not necessarily produce symtpoms

Question 20

Predisposing factors to gallstones?

Answer 20

Changes in the composition of bile that affect the solubility of its constituents
high blood cholesterol levels
diabetes
female
obesity
several pregnancies in young women, especially when paired with obesity

Question 21

What is the risk of leaving cholecystitis with no treatment

Answer 21

buildup of bile–> Inflammatory reaction
- bacterial infection
- - distension of the gallbladder

Question 22

ascending cholangitis complications if not treated

Answer 22

Cholangitis which is a complete obstruction of the bilary tree with infection if left the infection can spread upwards towards the liver, causing liver abscesses.