gallbladder

Question 1

Define cholelithiasis

Answer 1

stones in the gallbladder

Question 2

etiology of cholelithiasis

Answer 2

impaired metabolism of cholesterol, bilirubin and bile acids

Question 3

cholelithiasis: risk factors

Answer 3

Obesity, Sex (female), Middle ages, Use of oral contraception, Rapid weight loss, Indigenous American ethnicity, Genetic predisposition, Pancreatic or ileal disease

Question 4

cholelithiasis: CM

Answer 4

Usually asymptomatic, Epigastric and right quadrant pain, Intolerance to fatty foods, Vague symptoms: heartburn, flatulence, epigastric discomfort, food intolerances (fats and cabbage), Biliary colic, Jaundice

Question 5

cholelithiasis:
3 types of stones:

Answer 5

cholesterol, pigmented and mixed

Question 6

Biliary colic:

Answer 6

occurs 30 minutes to several hours after eating fatty meal

Question 7

cholelithiasis:
Severity depends on…..

Answer 7

Movement of stones & Obstruction

Question 8

Discuss WHY you might see jaundice, dark urine, clay colored stools, steatorrhea, pruritis, intolerance to fatty foods, and bleeding tendencies in someone with cholelithiasis.

Answer 8

Jaundice: Bile cannot flow into duodenum
Dark amber urine that foams when shaken: Soluble bilirubin in urine
Clay colored stools: Bilirubin does not reach small intestine to be converted into urobilinogen
Steatorrhea: No bile salts in duodenum, preventing fat digestion
Pruritis: Deposit of bile salts into skin tissues
Intolerance to fatty foods: no bile in small intestine to help with fat digestion
Bleeding tendencies: Decreased absorption of vitamin K

Question 9

Define cholecystitis

Answer 9

distended & inflamed gallbladder

Question 10

cholecystitis: etiology

Answer 10

a gallstone lodged in the cystic duct

Question 11

cholecystitis: lab values

Answer 11

increased bilirubin and alk phos

Question 12

cholecystitis: patho

Answer 12

Pressure against distended wall of the gallbladder leads to decreased blood flow -> ischemia, necrosis, perforation

Question 13

cholecystitis: CM

Answer 13

fever, leukocytosis, rebound tenderness, and guarding.

Pain is similar to biliary colic or cholelithiasis issues

Question 14

List the types of drugs we might give to a patient with gallbladder problems, and why.

Answer 14

Analgelsic: ketorolac (Toradol): pain control
Antiemetics: N/V
Anticholinergics: Decrease gallbladder secretion and stop smooth muscle spasms
Bile acids (rarely used): dissolve stones