Gallbladder Flashcards
cholelithiasis
stones in galbladder
etiology: impaired metabolism of cholesterol, billy, bile acids
3 types: cholesterol, pigmented, mixed
cholelithiasis: rf
obsese, F, middle age, use of oral contraception, rapid weight loss, indigenous, genetics, pancreatic or ileal disease
fair, fat, forty
cholelithiasis: cm
usually asymp
epigastric and RUQ pain -> usually intermittent but can be continuous, radiate to back, v severe (biliary colic: 30 min - several hrs after fatty meal; due to stone lodged in cystic/common duct during contraction of gallbladder
intolerance to fatty foods -> due to increased intake?
vague s: heart burn, flatulence, epigastric discomfort, food intol (fats and cabbage)
jaundice -> severe s, if stone blocks bile duct -> cant flow into duodenum
severity depends on movement of stones, obstruciton
cholelithiasis: cm - obstructed bile flow
jaundice
dark amber urine that foams when shaken -> soluble billy in urine
clay colored stools -> billy cant reach small intenstine to be converted to urobilinogen
steatorrhea (fatty stools) -> no bile salts in duodenum, prevent fat digestion
pruritus -> deposit bile salts into skin tissues
intol to fatty foods -> no bile in SI to digest fat
bleeding tendencies -> decrease abs of vit K -> clotting factor
cholecystitis
gallbladder inflam
acute or chronic (scaring and degeneration with chronic so usually remove)
most often caused by galstone lodged in cystic duct for a while
leads to distention in inflammed gallbladder
pain is similar to biliary colic or cholelithiasis issues
P against distended wall of gallbladder leads to decreased BF -> ischemia, narcosis, perforation
cholecystitis: cm
fever, leukocytosis, rebound tenderness, guarding
labs: elevated billy and alk phos
cholecystitis: tm
ketorolac (analgesic) -> pain, but use opioid if pain not controlled with this
odenestron (antiemetic) -> n/v
anticholinergics -> decrease gallbladder secretion and stop SM contractions
bile acids (rarely used) -> dissolve stones, if pt cant have sx
