Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI #2 > gallbladder disease > Flashcards

gallbladder disease Flashcards

1
Q

what stimulates CCK release into bloodstream

A

fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what stimulates contraction of GB

A

CCK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the diagnostic imaging modality?

IV injection of a radiotracer that is excreted by liver into bile and into GB.

List 3 things it can evaluate

A

HIDA
non-filling GB, leaks after surgery & measure CCK ejection fraction (33% + is normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

a HIDA scan that shows non-filling GB at 4 hours is diagnostic for? how does this condition cause non-filling?

A

acute cholecystitis– pressure builds up to the point that bile wont flow in via ducts of luschka

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the condition? imaging? Treatment?

  • persistent,progressive RUQ pain that may wrap around the R side; may have fever
  • Positive Murphy’s sign
  • Leukocytosis/elevated WBC; mildly elevated bili,AST/ALT, ALP, etc.
A

acute cholecystitis
- US first– wall thickening, distention, pericholecystic fluid
- HIDA would show non-filling
- tx: URGENT cholecystectomy, IV abx (Metro + cephalosporin or fluoroquinolone); if too sick then cholecystostomy tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • non-invasive specialized MRI to evaluate the intra/extra-hepatic biliary ducts
  • ordered if not obvious that there is a stone or a complication, if concern for mass
A

MRCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is acute cholecystitis in one sentence (what is causing it and where)

A
  • persistent inflammation & infection of gallbladder d/t gallstone obstruction at the cystic duct
  • pain often precipitated by large or fatty meal (d/t CCK release causing GB contraction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  • cannulation of the biliary tree through direct visualization via side viewing endoscope
  • diagnostic & therapeutic– stone removal, stenting, sphincterotomy, Bx, brushings, US
A

ERCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

only study that is both diagnostic and therapeutic for choledocolithiasis

A

ERCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

procedure where you insufflate abdomen, place ports using the bottom up technique

A

laparoscopic chole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tx used only in poor surgical candidates where you use ursodiol for 2 yrs to eliminate gallstones. it reduces cholesterol saturation of bile and only for stones under 5mm
- has high recurrence rate

A

dissolution therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the condition? imaging? Treatment?

  • usually asymptomatic; sx of episodic RUQ pain that can also be associated with meals
  • normal labs
A

Acute cholelithiasis
US
Observation if asymptomatic/incidental; cholecystectomy if symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe cholelithiasis in one sentence. what are the 3 types?

A
  • gallstones in gallbladder
  • Cholesterol–most common; mixed
  • Black– hemolysis or alcohol
  • brown– infection
  • sludge–thick bile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 things sludge is associated with

A

TPN
starvation
rapid weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the condition? Treatment?

  • intermittent (1-4hrs) RUQ pain worse after fatty meals; may wrap around R side
  • dyspepsia
  • No fever
  • normal labs
  • US: stones; possible mild wall thickening
A

chronic cholecystitis
elective lap cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the two severe cases of acute cholecystitis? what is the treatment for both?

A

acute gangrenous cholecystitis
acute emphysematous
tx: broad spectrum abx + emergent cholecystectomy

“emphy-see-matous”

17
Q

a severe case of acute cholecystitis with higher leukocytosis, systemic illness, may see perforation on imaging

A

acute gangrenous cholecystitis

18
Q

a severe case of acute cholecystitis that is secondary to gas forming bacteria, more common in older ppl or ppl w/ DM, may see air in the GB wall on XR

A

acute emphysematous cholecystitis

19
Q

what is the condition? imaging? Treatment?

  • critically ill patient (on TPN, ventilator, etc) where taking history & P.E is difficult but has increasing leukocytosis of unknown origin & mild LFT elevation
A

acalculous cholecystitis
US: distention, thickening, fluid, maybe murphy’s sign
tx: may need cholecystotomy tube secondary to other issues

20
Q

what is the condition? imaging? Treatment?

  • non-specific RUQ pain, light stools w/ dark urine, jaundice
    - high direct bilirubin, ALP, GGT
  • mild increase in AST/ALT
A

choledocholithiasis
US(dilated CBD), MRCP, ERCP
tx: monitor to see if it passes, if not then- ERCP or cholecystectomy if that fails

21
Q

describe acalculous cholecystitis

A

necroinflammatory gallbladder disease NOT from gallstones; from stasis and ischemia

22
Q

what is choledocholithiasis in simple words

A

gallstones in the common bile duct

23
Q

what is the condition? Imaging? Treatment?

  • charcots triad + reynolds pentad
  • left shift leukocytosis; neutrophil predominance
  • elevated ALP,GGT, direct bili, LFT
A

cholangitis
US/CT, MRCP,ERCP
tx: emergent ERCP or surgery

24
Q

what is charcot’s triad & reynolds pentad

A
  1. Jaundice
  2. RUQ pain
  3. chills & fevers
    reynolds pentad
  4. altered mental status
  5. hypotension
25
Q

what is cholangitis in simple term?

A

when there is choledolithiasis + infection that ascends up; patient goes from talking to you to septic then dead in a matter of hours!

26
Q

whats the condition? imaging (2)? treatment?

  • severe epigastric pain radiating to the back W/O ETOH history
  • large increase in amylase and lipase; mild LFT increase
A

gallstone pancreatitis
US: Gallstones
CT: pancreatic inflammation
Tx: fluids, repeat labs, ERCP in severe cases, cholecystectomy before discharge

27
Q

in simple terms, what is gallstone pancreatitis?

A

obstruction from gallstone at pancreatic duct

28
Q

whats the condition? imaging (2)? treatment?

  • biliary colic sx +/- N/V
  • dyspepsia
  • intermittent mild epigastric or RUQ tenderness
  • normal labs
A

biliary dyskinesia
US: normal
HIDA: EF < 33%, pain w/ CCK injection
tx: elective lap cole, lifestyle modifications

29
Q

what is biliary dyskinesia in simple terms

A

GB does not squeeze properly; NO STONES involved

GI #2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions