Gallbladder Flashcards

1
Q

Cholelithiasis

A

Stones in Gallbladder

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2
Q

Why does Cholelithiasis happen?

A

Etiology: Unknown

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3
Q

Cholelithiasis: Risk Factors

A
  • Gender (little higher in females)
  • Age (<40)
  • Estrogen (higher)
  • Lifestyle (obese or sedentary)
  • Diet (cholesterol + fat, low fiber)
  • Family History
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4
Q

Where does bile come from?

A

Liver, then stored in gallbladder

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5
Q

Function of Bile

A

Function: Digest lipids and transport waste

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6
Q

What’s in bile?

A

Components:

  • Bilirubin
  • Cholesterol
  • Bile salts
  • Water
  • Protein + Calcium
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7
Q

Cholelithiasis: Pathogenesis

A
  1. Bile Stasis
  2. Super Saturation with cholesterol
  3. Precipitation
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8
Q

Where do gallbladder stones go?

A

remain in gallbladder or migrate through bile ducts

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9
Q

Cholelithiasis possible results

A
  1. Pain
  2. Obstruction
  3. Cholecystitis (inflammation of gallbladder if blocked duct)
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10
Q

Cholelithiasis can be?

A

Silent

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11
Q

Severity of Cholelithiasis depends on

A
  • Movement of stones

- Obstruction

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12
Q

Major manifestation of Cholelithiasis

A

Biliary Colic

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13
Q

Biliary Colic

A

when stones move into biliary tree.

  • Steady, Severe pain (1 hr)
  • RUQ, may radiate to right shoulder
  • 3 to 6 hours after fatty meal
  • Tachy, diaphoresis,
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14
Q

Obstructed Bile Flow Manifestations 1

A

Jaundice:
-Bile cannot flow into duodenum (direct/conjugated)

Dark amber urine that foams when shaken:
-Soluble bilirubin in urine

Clay colored stools:
-Bilirubin does not reach small intestines to be converted into urobilinogen (brown color of stool)

Steatorrhea: (fat in stool)
-No bile salts in duodenum, preventing fat digestion

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15
Q

Obstructed Bile Flow Manifestations 2

A

Puritis:
-Bile salts deposit in to skin tissues

Intolerance to fatty foods:
-No bile in small intestines to help with fat digestion

Bleeding tendencies:
-Decreased absorption of vitamin K (need bile to absorb)

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16
Q

Gallstones are caused by what?

A

Abnormal accumulation of bile salts/other substances (Primarily Cholesterol)

17
Q

Most common cause of Cholecystitis

A

-Obstruction from gallstones or biliary sludge (sticky and thick like motor oil)

18
Q

Other causes of Cholecystitis

A
  • Prolonged immobility/fasting
  • Bacterial infection
  • Parenteral nutrition
  • Diabetes mellitus (DM)
19
Q

In Cholecystitis, the obstruction causes

A

Inflammation

20
Q

In Cholecystitis the Gallbladder becomes

A
  • Edematous (edema)
  • Hyperemic (increased blood flow to various parts)
  • Distended (swollen)
21
Q

Overtime in Cholecystitis, what happens?

A

Scaring and decreased function

-eventually will have GB removed due to ineffectiveness

22
Q

Systemic Symptoms of Cholecystitis

A
  • Fever
  • Chills
  • N//V
  • Restlessness
23
Q

Cholecystitis Lab values

A
  • Bilirubin (Inc)
  • Liver Enzymes (Inc)
  • WBC (Inc)
  • Amylase (Inc)
24
Q

Cholecystitis can lead to

A

Peritonitis

25
Q

Gallbladder Treatment with drugs

A

Analgesic: Ketorolac (Toradol)

Antiemetics:
-N/V

Anticholinergics:
-Dec GB secretion and stop smooth muscle spasms (in bile duct)

Bile acids: (rarely used)
-Dissolve stones