Gallbladder and Esophagus Pathology Flashcards

1
Q

Where are cholesterol gallstones most prevalent?

A
  • Most prevalent in US and western Europe

- Also higher rates in Native Americans

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2
Q

Where are pigment gallstones most prevalent?

A
  • Non-western populations
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3
Q

What is the main cause of pigment gallstones?

A
  • Bacterial infections or parasitic infestations of the biliary tree
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4
Q

Where are pigment gallstones found?

A
  • Sterile gallbladder
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5
Q

Where are brown gallstones found?

A
  • Infected large bile ducts
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6
Q

Who are gallstones most often seen in?

A
  • Females
  • Fair skinned
  • Fat
  • Forty
  • Fertile
  • Family history
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7
Q

What is the major symptom of gallstones?

A
  • Pain, often initiated after a fatty meal, localized to the RUQ or epigastrium (may radiate to right shoulder)
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8
Q

What are some severe complications of gallstones?

A
  • Empyema
  • Perforation
  • Fistula
  • Inflammation of the biliary tree
  • Obstructive cholestasis
  • Pancreatitis
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9
Q

What size of stones are the most dangerous and why?

A
  • Smaller stones are more dangerous because they are able to move and obstruct the cystic or common ducts
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10
Q

What are gallstones associated with?

A
  • Increased risk of gallbladder carcinoma
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11
Q

What is one of the main causes of acute cholecystitis?

A
  • Obstruction of the neck of the gallbladder or the cystic duct by a stone
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12
Q

What are the most common symptoms of acute cholecystitis?

A
  • Mild fever
  • Anorexia
  • Tachycardia
  • Sweating
  • Nausea
  • Vomiting
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13
Q

What does hyperbilirubinemia suggest in acute cholecystitis?

A
  • Obstruction of the common bile duct
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14
Q

What may cause chronic cholecystitis?

A
  • A sequel to repeated bouts of mild to severe acute cholecystitis, but in many instances it develops in the apparent absence of antecedent attacks
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15
Q

What are the clinical features of chronic cholecystitis?

A
  • Recurrent attacks of either steady epigastric or RUQ pain

- Will have nausea, vomiting, and intolerance for fatty foods

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16
Q

What complications are seen in both acute and chronic cholecystitis making diagnosis important?

A
  • Bacterial superinfection with cholangitis or sepsis
  • Gallbladder perforation with local abscess formation
  • Gallbladder rupture with diffuse peritonitis
  • BIliary enteric fistula
  • Aggravation of preexisting medical illness, with cardiac, pulmonary, renal, or liver decompensation
  • Porcelain gallbladder
17
Q

What geographical distribution is seen with adenocarcinoma?

A
  • Highest rates in US, UK, Canada, and Australia
18
Q

Which group has the highest risk of adenocarcinoma?

A
  • Caucasians

- 7x more likely in men

19
Q

What are the risk factors for adenocarcinoma?

A
  • Barrett esophagus
  • Tobacco
  • Radiation
  • H. pylori
20
Q

How does adenocarcinoma initially appear?

A
  • As flat or raised patches in otherwise intact mucosa
21
Q

Where is adenocarcinoma of the esophagus usually seen?

A
  • Distal third of esophagus
22
Q

What are the clinical features of adenocarcinoma?

A
  • Usually discovered in evaluation of GERD or surveillance of Barrett esophagus
  • Most commonly present with pain or difficulty in swallowing, progressive weight loss, hematemesis, chest pain, or vomiting
23
Q

What is the geographical distribution of SCC?

A
  • Iran
  • Central China
  • Hong Kong
24
Q

What group has the highest risk of SCC?

A
  • > 45
  • Males 4:1
  • African Americans are 8x more likely
25
Q

What are some risk factors for SCC of the esophagus?

A
  • Alcohol and tobacco
  • Poverty
  • Caustic esophageal injury
  • Achalasia
  • Tylosis
  • Radiation
  • Plummer-Vinson syndrome
  • Diets that are deficient in fruits or vegetables
  • Frequent consumption of hot beverages
26
Q

Where is SCC of the esophagus usually seen?

A
  • Upper 2/3 of the esophagus
27
Q

How does someone with SCC present?

A
  • Dysphagia
  • Odynophagia
  • Obstruction
  • Patients will progressively change their diet from solids to liquids as the tumor grows
28
Q

What are the symptoms of SCC of the esophagus?

A
  • Dysphagia
  • Odynophagia
  • Obstruction
  • Patients will alter diet to eat more liquids than solids due to tumor size