Gallbladder Flashcards

0
Q

Pathophysiology of a biliary colic? Triggered by? Accompanied symptoms? Signs that are not seen? Time course? Can be aborted by?

A

Stone temporarily occludes cystic duct; nausea and vomiting; no signs of peritoneal irritation or systemic signs of inflammatory process; 10-30 minutes; anti-cholinergics

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1
Q

Ethnicities that have a higher incidence of gallstones?

A

Native Americans and Mexican-Americans

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2
Q

Radiation of pain from biliary colic extends to?

A

Right shoulder and back

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3
Q

Acute cholecystitis (versus Biliary colic)? Time course? Associated findings? Effect on LFTs?

A

Occlusion cystic duct by stone, and stone remains in cystic duct until inflammatory process develops

Constant pain, fever and leukocytosis, signs of peritoneal irritation

No changes

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4
Q

HIDA scan shows uptake in liver, common bile duct, duodenum, but not in gall bladder – diagnosis?

A

Cholecystitis

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5
Q

Management of acute cholecystitis? If no response? Who is likely to have no response?

A
  1. NPO, NG tube, IV fluids
  2. Antibiotics
  3. After cooldown phase, elective cholecystectomy

Emergency cholecystectomy; diabetics and men

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6
Q

Gallbladder obstruction that affects older patients with temperature spikes and very high WBC counts? Management?

A

Acute ascending cholangitis

  1. IV antibiotics
  2. emergency decompression (ERCP, or percutaneous transhepatic cholangiogram)
  3. Followed with cholecystectomy
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7
Q

Gallstone pancreatitis - stone impacted where?

A

Ampulla

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