gall stones

Question 1

definition of ‘Cholelithiasis’

Answer 1

presence of gallstones in the gallbladder

Question 2

definition of ‘Choledocholithiasis’

Answer 2

presence of gall stones in the common bile duct

Question 3

definition of ‘Cholecystitis’

Answer 3

inflammation of the gall bladder

Question 4

What factors increase gall stone formation?

Answer 4

1. imbalance of bile salts - lecithin/cholesterol/calcium

2. Bile stasis - impaired gallbladder emptying

Question 5

What are the three types of gall stones?

Answer 5

1. Cholesterol stones
2. Black stones
3. Mixed Brown pigment sones

Question 6

which is the most common type of gall stone?

Answer 6

cholesterol stone

Question 7

Name 4 major risk factors for cholesterol stones?

Answer 7

1. Obesity
2. Pregnancy /Female sex
3. Family history
4. Malabsorbtion
   - crohns/cystic fibrosis

(6Fs - fat,female,fertile,fourty.family history)

Question 8

cholesterol stones - pathophys

Answer 8

1. abnormal hepatic cholesterole metabolism
2. leads to high cholesterole concentration in hype
3. hypersaturated - precipitation of cholesterole

Question 9

black pigment stones - pathophys

Answer 9

1. increased haemolysis
2. increased uptake and conjugation of bilirubin
3. black pigment stones form

Question 10

black pigment stones - risk factors

Answer 10

1. increased hemolysis
2. increased unconjugated billirubin
3. increased conjugation and bilirubin in bile
4. high concentration of bilirubin in the bile causes black pigment stone

Question 11

mixed/brown pigment stones - risk factors

Answer 11

bacterial infections and parasites

Question 12

clinical features of gall stones

Answer 12

1. most are asymptomatic
2. Biliary colic
   - constant dull RUQ pain
   - lasts > 6 hours
   - post prandial
   - radiates to right shoulder and back