Gallbladder

Question 1

what is cholelithiasis

Answer 1

stones in the gallbladder

Question 2

cause of cholelithiasis

Answer 2

unknown

Question 3

risk factors for cholelithiasis

Answer 3

gender
age
estrogen
lifestyle
diet
fam hx

Question 4

what is bile

Answer 4

helps digest lipids and transport waste products

Question 5

where is bile produced

Answer 5

liver

Question 6

where is bile stored

Answer 6

gall bladder

Question 7

components of bile

Answer 7

bilirubin
cholesterol
bile salts
water
protein
calcium

Question 8

pathogenesis of cholelithiasis

Answer 8

bile stasis –> super saturation with cholesterol –> precipitation (gall stones) –> migration of stones through ducts

Question 9

cholelithiasis clinical manifestations

Answer 9

sometimes silent
severity depends on movement of stones, obstruction
biliary colic

Question 10

what is biliary colic

Answer 10

steady and severe pain that lasts for about an hour
RUQ may radiate to right shoulder
occurs 3-6 hrs after fatty meal consumed
other sx are inc HR, diaphoresis, epigastric like pain

Question 11

obstructed bile flow manifestations

Answer 11

jaundice
dark amber urine that foams when shaken
clay colored stool
steatorrhea

Question 12

why does jaundice occur with bile flow obstructions

Answer 12

bile cant flow into duodenum
- back up of conjugated bilirubin gets into the blood

Question 13

what does dark amber urine occur with bile flow obstructions

Answer 13

soluble bilirubin in urine

Question 14

what does clay colored stools occur with bile flow obstructions

Answer 14

bilirubin does not reach small intestine to be converted into urobilirubin

Question 15

why does steatorrhea occur with bile obstruction

Answer 15

no bile salts in duodenum, preventing fat digestion

Question 16

why does puritis occur with bile flow obstruction

Answer 16

deposition of bile salts into skin tissue

Question 17

what does intolerance to fatty foods occur with bile flow obstructions

Answer 17

no bile in the small intestine to help with fat digestion

Question 18

why do bleeding tendencies happen with bile flow obstruction

Answer 18

decreased absorption of vitamin K

Question 19

cholecystitis

Answer 19

inflammation of gallstones or biliary sludge

Question 20

causes of choecystitis

Answer 20

prolonged immobility/fasting
bacterial infection
parenteral nutrition
DM

Question 21

pathogenesis of cholecystitis

Answer 21

obstruction that causes inflammation
- obstruction causes gallbladder to become edematous, hyperemic, distended

Question 22

what happens because of long term obstruction

Answer 22

scarring and decreased function

Question 23

cholecystitsis clinical manifestation

Answer 23

fever
NV
restlessness
diaphoresis

Question 24

what labs are affected w cholecystisis

Answer 24

bilirubin
liver enzymes
WBC
amylase

Question 25

pharm for gallbladder problems

Answer 25

• analgesics for pain control
• antiemetics for NV
• anticholinergics for dec gallbaldder secretion and stop smooth muscle spasms
• bile acids are rarely used but used to dissolve stones