Gallbladder

Question 1

Where is the gallbladder

Answer 1

below the liver

Question 2

What does the gallbladder store

Answer 2

bile until it is released into the cystic duct

Question 3

What is cholecystitis

Answer 3

inflammation of the gallbladder (can be acute or chronic)

Question 4

Risk factors for cholecystitis

Answer 4

women, age 40+, high calorie and cholesterol diet, oral contraceptives, genetics, obesity, rapid weight loss

Question 5

When does cholecystitis most commonly occur

Answer 5

biliary stasis and gallstones

Question 6

Calculous cholecystitis

Answer 6

caused by gallstones that lodge in the cystic duct (90% of all cases)

Question 7

Acalculous cholecystitis

Answer 7

caused without evidence of gallstones or cystic duct obstruction

Question 8

Pathophysiology of cholecystitis

Answer 8

obstruction of the cystic duct by gallstones –> distension of the gallbladder –> compromised blood flow and lymphatic drainage –> necrosis

Question 9

What causes cholecystitis pain

Answer 9

irritation of surrounding nerves from gallbladder distension

Question 10

Biliary colic

Answer 10

pattern of spasmodic pain

Question 11

Biliary stasis

Answer 11

problem with the liver that inhibits its ability to secrete bile into the bile ducts

Question 12

What causes biliary colic

Answer 12

decreased distension, pain decreases

Question 13

Chronic cholecystitis

Answer 13

when the gallbladder becomes thickened, rigid, and fibrotic

Question 14

What causes changes in gallbladder structure

Answer 14

multiple attacks of cholecystitis, calculi, chronic irritation

Question 15

Laboratory tests to diagnose cholecystitis

Answer 15

WBC, ESR, CRP, liver enzymes, bilirubin levels

Question 16

Abnormal ultrasound findings in cholecystitis

Answer 16

presence of stones, thickening of the wall, distension

Question 17

Cholecystogram

Answer 17

assessment of gallbladder function, special diet is consumed before and contrast tablets are taken

Question 18

Diet treatment of cholecystitis

Answer 18

avoid food during acute attacks, NG tube to relieve nausea and vomiting, limit fat intake, fat-soluble vitamins and bile salts if bile flow is obstructed

Question 19

Medication treatment of cholecystitis

Answer 19

narcotic analgesic, oral meds to dissolve gallstones, meds to bind with bile salts to promote excretion in the feces in patients with pruritis

Question 20

What narcotic analgesics are used

Answer 20

dilaudid because morphine can cause spasms in the biliary duct increasing pain

Question 21

What medication is used to dissolve gallstones

Answer 21

Ursodiol

Question 22

What medication is used in patients with pruritis to promote excretion of bile salts in the feces

Answer 22

Questran

Question 23

When are laparoscopic cholecystectomies used

Answer 23

used in cases of both cholelithiasis and cholecystitis

Question 24

What is a laparoscopic cholecystectomy

Answer 24

removal of the gallbladder

Question 25

Transhepatic tube use

Answer 25

maintains patency of common bile duct, promotes bile passage, decreases edema