gallbladder disorders

Question 1

cholelithiasis

Answer 1

stones in the gallbladder

Question 2

cause of gallbladder stones

Answer 2

UNKNOWN

Question 3

risk factors for gallbladder stones (cholelithiasis)

Answer 3

gender
age
estrogen
lifestyle (obese + sedentary)
diet
family hx

Question 4

function of bile

Answer 4

help digest lipids and transport waste products

Question 5

components of bile

Answer 5

bilirubin, cholesterol, bile salts, water, protein, and calcium

Question 6

where does bile come from?

Answer 6

produced in liver and store in gallbladder

eating a meal that contains fat signals gallbladder to release bile then flows into duodenum

Question 7

patho of cholelithiasis

Answer 7

bile stasis –> super-saturation with cholesterol –> precipitation

stones remain in gallbladder and migrate through ducts - can cause pain, obstruction, cholecystitis

Question 8

clinical manifestations of cholelithiasis

Answer 8

-sometimes silent
*severity dependent on: movement of stones, obstruction
-biliary colic

Question 9

biliary colic means

Answer 9

steady, severe pain ~1 hr
RUQ, may radiate to R shoulder
occurs:
S/S:

Question 10

obstructed bile flow: clinical manifestations

Answer 10

-jaundice
-dark amber urine that foams when shaken
-clay colored stools
-steatorrhea
-pruritis
-intolerance to fatty foods
-bleeding

Question 11

obstructed bile flow: jaundice

Answer 11

bile cannot flow into duodenum

Question 12

obstructed bile flow: dark amber urine that foams when shaken

Answer 12

soluble bilirubin in urine

Question 13

obstructed bile flow: clay colored stools

Answer 13

bilirubin does not reach small intestine to be converted into urobilinogen

Question 14

obstructed bile flow: steatorrhea

Answer 14

no bile salts in duodenum - prevents fat digestion

Question 15

obstructed bile flow: pruritis

Answer 15

deposit of bile salts into skin tissue

Question 16

obstructed bile flow: intolerance to fatty foods

Answer 16

no bile in small intestine to help with fat digestion

Question 17

obstructed bile flow: bleeding tendencies

Answer 17

decreased absorption of vitamin K

Question 18

cause of cholecystitis

Answer 18

most common: obstruction from gallstones or biliary sludge

-prolonged immobility/fasting
-bacterial infection
-parenteral nutrition
-diabetes mellitus

Question 19

patho of cholecystitis

Answer 19

obstruction –> inflammation

gallbladder becomes: edematous, hyperemic, distended

over time: scarring and decreased functioning

Question 20

clinical manifestations of cholecystitis

Answer 20

similar to cholelithiasis

systemic: fever, N/V, restlessness, diaphoresis

Question 21

lab values of cholecystitis

Answer 21

bilirubin, liver enzymes (ALT&AST), WBC, amylase

Question 22

peritoneal involvement in cholecystitis

Question 23

drugs to give for gallbladder problems

Answer 23

-analgesis (ketorolac)
-antiemetics
-anticholinergics
-bile acids

Question 24

analgesics are given for

Answer 24

pain control

Question 25

antiemetics are given for

Answer 25

N/V

Question 26

anticholinergics are given for

Answer 26

decrease gallbladder secretion and stop smooth muscle spasms

Question 27

bile acids are given for

Answer 27

dissolve stones

**rarely used