Gallbladder and Biliary Tract DZ

Question 1

What is the most common tumor of the biliary tract?

Answer 1

Cholangiocarcinoma

Question 2

What is the most common cause of cholangiocarcinoma?

Answer 2

Primary sclerosing cholangitis

Question 3

Primary sclerosing cholangitis has a strong association with what IBD?

Answer 3

Ulcerative colitis

Question 4

What are common clinical findings associated with cholangiocarcinoma?

Answer 4

Obstructive jaundice, palpable gallbladder

Question 5

Define cholelithiasis.

Answer 5

Gallstones

Question 6

What are the types of gallstones? What is their composition?

Answer 6

Cholesterol stones- cholesterol

Pigment stones- bilirubin (associated with hemolytic anemia)

Question 7

Which type of gallstone tends to be radiopaque?

Answer 7

Pigment stones

Question 8

What are the risk factors for gallstones?

Answer 8

Female, fat, fertile, 40, family

Question 9

What are the complications associated with gallstones?

Answer 9

Cholecystitis (most common), CBD obstruction

Question 10

What are common clinical/lab findings with cholecystitis?

Answer 10

Vomiting, epigastric/RUQ pain, neutrophilic leukocytosis, + Murphy’s sign

Question 11

What test is the gold standard to diagnose cholecystitis?

Answer 11

Ultrasound

Question 12

Define choledocholithiasis.

Answer 12

Gallstone obstructing the CBD.

Question 13

What are common laboratory findings associated with choledocholithiasis?

Answer 13

Elevated alk phos and bilirubin

Question 14

Gallbladder adenocarcinoma is associated with what dz?

Answer 14

Cholelithiasis

Question 15

What hormone stimulates contraction of the gallbladder?

Answer 15

CCK

Question 16

What are the major causes of acute pancreatitis?

Answer 16

EtOH and gallstones

Question 17

What is the most common cause of acute pancreatitis in children ?

Answer 17

Seat belt trauma

Question 18

What is the typical presentation of a patient with acute pancreatitis?

Answer 18

Severe midepigastric pain with radiation into the back

Question 19

What is Charcot’s triad? What does this indicated?

Answer 19

RUQ pain, jaundice, fever- acute cholangitis

Question 20

What is Reynold’s pentad?

Answer 20

Charcot’s triad + hypotension and confusion

Question 21

What causes chronic pancreatitis?

Answer 21

Repeated attacks of acute pancreatitis

Question 22

In order for malabsorption to occur in the presence of chronic pancreatitis, what % of pancreatic exocrine function must be destroyed?

Answer 22

90%

Question 23

A CT/plain film of the pancreas will demonstrate what finding in the setting of chronic pancreatitis?

Answer 23

Dystrophic calcifications

Question 24

What are causes of adenocarcinoma of the pancreas?

Answer 24

Smoking, chronic pancreatitis

Question 25

What tumor marker is associated with pancreatic adenocarcinoma?

Answer 25

CA19-9