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GI > Gallbladder > Flashcards

Gallbladder Flashcards

1
Q

What does the gallbladder respond to?

A

Cholecystokinin (CCK)

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2
Q

What is released from the gallbladder and what is its function?

A

Bile – function is to break up fats

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3
Q

What is bile made up of?

A

Bile salts, bilirubin, and alkaline fluids

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4
Q

What does cholecystic mean?

A

Referring to the GB

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5
Q

What does cholecystitis mean?

A

Inflammation & stone in the cystic duct

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6
Q

What does cholelithiasis mean?

A

Stones in the GB

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7
Q

What does choledocholithiasis mean?

A

Stone in the bile duct

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8
Q

What does cholecystectomy mean?

A

Surgical removal

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9
Q

What does cholecystalgia mean?

A

Pain

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10
Q

What is the majority of a gallstone made of?

A

Cholesterol

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11
Q

If a patient presents with RUQ and epigastric pain, what diagnosis should immediately be on your differentials?

A

Cholecystitis

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12
Q

Where does cholecystits pain radiate to?

A

Right shoulder/subscapular region

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13
Q

What is occurring in cholecystitis?

A

Gallstone obstructing the cystic duct, leading to impaired venous return, which can become ischemic

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14
Q

Can a patient have N/V with acute cholecystitis?

A

Yes

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15
Q

What PE test can you perform for cholecystitis, what would you see?

A

Murphy’s sign – tenderness & patient stops inspiration on palpation of RUQ

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16
Q

How do you confirm diagnosis of cholecystitis?

A

Ultrasound – see the gallstones & GB wall thickening!

Can also do a HIDA scan

17
Q

What labs would you want to order with cholecystitis? What would you typically see?

A

CBC (WBC = 12-15K), LFTs, Alkaline phosphatase, GGT, bilirubin, and amylase = all elevated

18
Q

What would the elevation of the LFT’s have to be to truly point us in the direction of a liver disorder?

A

At least 3x higher

19
Q

How would you treat cholecystitis?

A

Cholecystectomy! Could drain it if the patient is too ill. Abx if fever and/or leukocytosis

20
Q

The presence of a gallstone is known as? Where did it come from?

A

Cholethiasis

Comes from cholesterol

21
Q

Physiologically, what causes cholethiasis?

A

Bile become supersaturated with cholesterol, the cholesterol crystallizes, and the gallbladder is slow to empty.

22
Q

When would the gallbladder have the lowest hyPOmotility?

A

During pregnancy

23
Q

Who is most at risk of developing cholesthiasis?

A

The five F’s = female, fat, 40, fair, and fertile

Obesity (or rapid weight loss)

24
Q

Do people typically present with symptoms with cholesthiasis?

A

No, no symptoms usually until it becomes cholecystits

25
Q

How do you confirm diagnosis of cholesthiasis?

A

Ultrasound! – you will NOT see gallbladder wall thickening

26
Q

How do you treat cholesthiasis?

A

If it hurts, take it out. If not, leave it in. Unless there are other complications (reasons) to take it out – diabetes, sickle cell.

Can dissolve stones with Ursodiol, Actigall, or Chenix

27
Q

What if on ultrasound, you see that the stone is located in the common bile duct (rather than the cystic duct) what is this known as?

A

choledocholithiasis

28
Q

How do you confirm diagnosis and treat choledocholithiasis?

A

ERCP

29
Q

If a patient presents with RUQ pain, jaundice, and fever, what diagnosis are you thinking?

A

Acute cholangitis → Charcot’s Triad!

30
Q

What would the symptoms be known as if the person also had an altered mental status and hypotension?

A

Reynold’s Pentad

31
Q

If Reynold’s Pentad is present in a patient with choledocholithiasis, what does that mean?

A

Indicates sepsis, can become rapidly fatal

32
Q

What is occurring during acute cholangitis?

A

Infection of the biliary tract due to obstruction → can lead to sepsis/shock

33
Q

What labs would you order for acute cholangitis? What would you see?

A

CBC – leukocytosis with left shift

Hyperbilirubemia

Elevated alkaline phosphatase

34
Q

How would you confirm diagnosis of acute cholangitis?

A

RUQ ultrasound (initial test) then ERCP

35
Q

How would you treat a patient with acute cholangitis?

A

Get 2 cultures to see what Abx it will respond to (floroquinolones)

Remove obstructing stone with ERCP

GI (6 decks)

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