Gall Bladder Physiology

Question 1

Most common type of gallstone

Answer 1

Cholesterol (yellow stone)

Question 2

Less common type of gallstone

Answer 2

Pigment (made of bilirubin and calcium) (black/brown)

Question 3

How common are gallstones

Answer 3

Quite 10-20% of adults, but 80% of them silent

Question 4

Cause of gallstone formation

Answer 4

Bile supersaturated with cholesterol
- Obesity, rapid weight loss, estrogen favour

Question 5

Cholethialsis

Answer 5

Gallstones (but not doing much)

Question 6

Cholecystitis

Answer 6

Inflammation of gallbladder - normally from gallstone (obstruction of neck of gallbladder or cystic duct)

Question 7

Chronic Cholecystisis

Answer 7

Normally long-term association of gallstones -> inflammation over time

Question 8

Management of cholecystitis

Answer 8

Acute - Pain relief, IV, antibiotics. Not normally surgical

Chronic - Laparoscopy

Question 9

Choledocholithiasis

Answer 9

Stones within the biliary tree

Question 10

Cholangitis

Answer 10

Infection compounds choledocholithiasis = bacteria in the biliary tree

Question 11

Biliary cancers frequency

Answer 11

Rare

Question 12

Complications of gallbladder cancer

Answer 12

Hard to detect = most has invaded the liver by the time of diagnosis

Question 13

Where is bile reabsorbed

Answer 13

Terminal ilium (gets back to liver via portal vein)

Question 14

Bile functions

Answer 14

Carrying bile acids = absorption of fats and fat-soluble vitamins ADEK

Elimination of bilirubin

Question 15

Bile flow from origin to gallbladder

Answer 15

Made in hepatocyte -> canaliculi -> bile ducts -> L/R hepatic duct -> common hepatic duct -> cystic duct -> gallbladder

Question 16

Bile acid-dependent flow

Answer 16

Active transport of bile acids brings water along through osmosis

Question 17

Bile acid-independent flow

Answer 17

Other solutes and electrolytes draw water in to help with flow

Question 18

Bile homeostasis

Answer 18

95% recycled
5% excreted

Excreted amount should = synthesised amount ~15g

Question 19

What stimulates contraction of gallbladder to release bile

Answer 19

CCK and autonomic nervous system (parasymp)

Question 20

What is jaundice

Answer 20

Too much bilirubin in the blood

Question 21

Cause of jaundice

Answer 21

Obstruction to bile flow = bilirubin build up = enters blood = jaundice = yellow