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Old DOOS > Gallbaldder > Flashcards

Gallbaldder Flashcards

1
Q

stones present in GB

A

cholelithiasis

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2
Q

inflammation of GB, +/- stones (sludge)

A

cholecystitis

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3
Q

stone in CBD (common bile duct) causing pain, jaundice, pancreatitis
can be acute or chornic

A

Choledocholithiasis

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4
Q

stones or sludge in gallbladder that last for awhile

can have thickening of gallbladder wall and if it has calcium

A

chronic cholecystitis

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5
Q

what causes fatty food intolerance?

A

lack of bile salts

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6
Q

what causes episodic pain from the gallbaldder?

A

Intermittent obstruction

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7
Q

what causes pale feces?

A

lack of bile coloration

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8
Q

what causes pruritis from a gallbladder problem?

A

cholestasis, bile irritating skin

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9
Q

what is bile mostly made of?

A

Cholesterol from the liver

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10
Q

Of the 200-400 bilirubin produced each day, what happens to most of it?

A

fecal urobilinogen
some extreted in urine (urobilinogen)
some recycled

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11
Q

If urobilinogen is backing up in the systemic system, what might your urine look like?

A

Brown, like tea

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12
Q

with acute cholecystitis what will you have?

A 
Fever
Leukocytosis 
Alkaline phosphate elevate (from liver and bone) because GB is irritating liver 
may have N/V (ileus possible) 
pancreatitis, metabolic derangement's
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13
Q

What causes pancreatitis? from GB problem

A

If sludge, stone gets to distal end of bile duct and blocks the pancreatic duct.

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14
Q

Symptoms of pancreatitis

A

Band-like pain near umbilicus

Pancreas can hemorrhage

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15
Q

what is a metabolic derangement?

A

Electrolytes are way off
can become acidodic
blood sugar can shoot up due to lack of insulin

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16
Q

Big collections of air fluid levels can indicate what?

A

Ileus

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17
Q

Why are there not high pitched bowel sounds with an ileus

A

bowels aren’t moving

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18
Q

5 “F’s” for a GB problem

A 
Fat
Fertile
Female 
Forty 
Fasting
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19
Q

What is the BEST test to find gallstones?

A

Ultrasound

shows stones, size, fluid, measurement of dilation

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20
Q

How long should they fast before a GB US?

A

4-6 hours

should be a lot of bile stored, helps you see it better

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21
Q

Imaging procedure used to diagnose problems in the liver, gallbladder and bile ducts.
a radioactive chemical or tracer is injected into a vein in your arm.
The tracer is handled by the liver like bile.

A

HIDA scan

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22
Q

What can the CT of GB show?

A

May show stones, but doesn’t necessarily give you information about inflammation

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23
Q

If a person is very obese, what diagnostic method doesn’t work as well?

A

Ultrasound

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24
Q

What is an ERCP

A

endoscopic retrograde cholangiopancreatography

diagnostic and therapeutic effect

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25
Q

Risk factors for gallstones

A 
older, female
pima indians, and native amercians
obesity, rapid weight loss
cirrhosis
hemolytic anemia 
diabetes
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26
Q

What does a cholangiogram do?

A

Put catheter in liver, can drip dye in there
if there is an obstruction can put in a T tube so bile can be drained

look for stones that wandered further in the duct

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27
Q

If a diabetic has gallstones what should you do?

A

Plan a surgery to have it out before there is a problem

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28
Q

Is chemical gallstone dissolution helpful?

A

Not really, as soon as stop the drugs stones come back

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29
Q

Will there be an acoustic shadow with GI sludge?

A

no

30
Q

what are most cases of pancreatitis due to?

A

alcoholism and biliary tract dz

31
Q

what meds can cause pancreatitis?

A

hydrocholorthiazide

32
Q

what can cause pancreatitis?

A 
ulcer
trauma
tumor
meds
meatbolic disorders
33
Q

most common people to have acute pancreatitis

A

male alcoholism

females with gallstone

34
Q

What disease increases risk of acute pancreatitis?

A

AIDS

35
Q

Drugs that can cause acute pancreatitis?

A

thiazides, diuretics, gluco-corticosteroids, azathioprine, sulfasalazine, herbal remedies

36
Q

what are metabolic causes of acute pancreatitis?

A

hypercalcemia
hypertriglyceridemia
heredity

37
Q

With pancreatitis what will there be an elevation of what levels?

A

Serum isoenzymes

38
Q

What can you look for in the urine for acute pancreatitis?

A

Trypsinogen-2

39
Q

what will you experience w/ acute pancreatitis?

A 
Diabetic ketoacidosis
enzymatic insufficiency
calcium imbalance 
protein losses (ascities) 
hemorrhage and volume loss
40
Q

What often sits in the pancreas with pancreatitis?

A

calcium

41
Q

chronic pancreatitis causes

A 
Recurrent chronic alcoholics
biliary tract dz complications
hypercalcemia, hyperlipidemia 
AIDS
thiazides
42
Q

signs of pancreatitis

A

Band-like epigastric pain

Fever, N/V, Ileus

43
Q

what labs will be elevated with pancreatitis?

A

Serum amylase

Lipase

44
Q

IS ERCP helpful with pancreatitis?

A

Can be, but may exacerbate symptoms

Usually do after NPO and in hospital for a few days

45
Q

How do you treat pancreatitis?

A 
eliminate irritants (EtOH, fat, meds) 
Hospitalize for IV hydration
NPO and NG suction 
Antibiotics coverage for enterics
pain management, nutrition
46
Q

when do you start IV fluids and antibiotics with acute pancreatitis

A

When >30% of tissue is necrotic

47
Q

who is esophageal cancer common in?

A

smokers
alcoholics
Lye ingestions
advanced GERD

48
Q

most common type of esophageal cancer?

A

Epidermoid (squamous cell)

49
Q

Symptoms of esophageal CA

A 
Reflux
Odynophagia
Dysphagia
Regurgitation
Inaition (the "blahs")
50
Q

How does esophageal cancer spread?

A

Mucosa to mediastinum/ tachae

Regional nodes with rapid spread

51
Q

what blood type is more likely to get cancer?

A

Type A blood

52
Q

who is gastric CA common in

A

non-white

low socioeconomic status

53
Q

what is gastric cancer related to

A

environment
food prep
nitrates

54
Q

Risk factos for gastric Ca

A

H. pylori
previous gastric surgery (Bilroth II)
achlorhydria (inadequate acid)

55
Q

Most common cell type for gastric cancer?

A

adenocarcinomas

56
Q

some signs of gastric cancer

A

Iron deficiency anemia
Heme + stool
ascites
L Supra-clavicular node enlargement

57
Q

mainstay for diagnostic of gastric cancer?

A

endoscopy with biopsy and brushing

58
Q

ways to prevent gastric cancer

A

stop smoking/ alcohol
management of GERD
manage H. pylori
reduce nitrates in food prep

59
Q

who are colon and rectal carcinomas common in?

A

males

increases with age

60
Q

Is there a genetic connection with colon and rectal cancer?

A

yes, autosomal dominant familial adenomatous

61
Q

in the eastern world where are colorectal cancers more common?

A

right side of the colon

62
Q

more colorectal cancers develop from what type polyps?

A

adenomatous polyps

63
Q

what is the difference between synchronus and metachornus neoplasia?

A

synchronus came about at the same time, near eachother

metachronus is the opposite

64
Q

a polyp size greater than what has a worse prognosis?

A

1.5 cm

65
Q

where do most metastases from colorectal cancer go?

A

Liver due to portal circulation

66
Q

Risks with pancreatic cancer?

A

High alcohol and smoking habits
male
DM, chronic pancreatitic
dry cleaning and gasoline chemicals (may)

67
Q

Symptoms of pancreatic cancer?

A 
unexplained pain
weight loss
jaundice
depression
DVT
68
Q

How do you diagnose pancreatic cancer?

A

ultrasound and CT
percutaneous fine needle aspiration
endo retro cholangio pancreatography

69
Q

What are some cancer serum markers for pancreatic cancer?

A

CA 19-9

CEA

70
Q

15 % of the time with an unprovoked DVT what will a patient have?

A

An undiagnosed malignancy somewhere because malignancy makes the blood hyper-coaguable

71
Q

what part of the pancreas is pancreatic cancer likely to occur?

A

Head

72
Q

why might a person with pancreatic cancer have painless jaundice?

A

common bile duct obstruction

Old DOOS (21 decks)

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