gallbladder disease

Question 1

which organ produces bile

Answer 1

liver

Question 2

how does the body protect the gallbladders

Answer 2

with the secretion of mucin

Question 3

what does the ampulla of vater do?

Answer 3

it is usually closed but it prevents bile from draining into the intestine and instead flow into the gallbladder

Question 4

what does the gallbladder do the bile?

Answer 4

gallbladder stores bile and concentrates through absorption of water and small electrolytes

Question 5

3 important components of bile

Answer 5

1. cholesterol
2. bile salts
3. phospholipids (90% lecithin)

Question 6

chenodeoxyxhollic acid and cholic acid

Answer 6

types of bile acids

Question 7

bile acids are conjugated in the liver and then secreted into the bile… what are the conjugates

Answer 7

glycine and taurine

Question 8

bile acids circulate in the

Answer 8

enterohepatic circulation

Question 9

what does micelle do>

Answer 9

emulsify cholesterol and make it soluble in bile

Question 10

risks for developing gallstones

Answer 10

1. age
2. female sex due to the estrogen levels
3. pregnancy
4. obesity

Question 11

what is the composition of gallstones

Answer 11

contain bilirubin pigments, cholesterol and calcium salts

Question 12

black stones

Answer 12

made from unconjugated biliruibin with mucin glycoproteins

from chronic hemolysis or cirrhosis

Question 13

brown stones

Answer 13

bacteria or parasites

calcium salts of unconjugated bilirubin

Question 14

what happens if a stone impacted in distal common bile duct

Answer 14

jaundice, biliary colic-type pain, risk of ascending cholangitis or acute biliary pancreatitis

Question 15

stone impacted in cystic duct

Answer 15

acute cholecystitis

Question 16

pain from stones

Answer 16

right upper quadrant or epigastric tenderness

Question 17

what type of test will be high (hisgest to lowest..3)

Answer 17

1. AST
2. Alk. Phos
3. Bili

Question 18

biliary colic

Answer 18

when a gallstone blocks either the common bile duct or the cystic duct

Question 19

cholecystitis

Answer 19

either acute or chronic inflammation of the gallbladder

90% of acute cholecystitis cases are caused by the presence of gallstones
and inflammation is due to secondary infection with bacteria of an obstructed gallbladder, with the obstruction caused by the gallstone

Question 20

choledocholithiasis

Answer 20

gallstones obstruct a part of the bile duct.

• can cause jaundice and liver cell damage

Question 21

cholangitis

Answer 21

medical emergency; requires urgent antibiotics and endoscopic or surgical treatment such as a cholecystectomy

Question 22

gallstones ileus

Answer 22

gallbladder forms a fistula with the digestive tract and develops in patients with longstanding gallstone disease

• large stones pass into the bowel and can block the gut at the level of the ligament of treitz or the ileocecal valve

Question 23

HIDA scan

Answer 23

hepatobiliary scintiagraphy

• limited anatomic detail but assess bile leak and focal obstruction

Question 24

endoscopic retrograde pancreatography

Answer 24

stone extraction

Question 25

treatment for gallstones (4)

Answer 25

1. avoiding obesity and other risk factors
2. ursodeoxycholic acid
3. lithotripsy
4. surgery such as laparoscopic