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Gastroenterology > Gallbladder disorders > Flashcards

Gallbladder disorders Flashcards

1
Q

Cholelithiasis

A

Formation of gallstones generally in the gallbladder.

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2
Q

Gallstones are made of?

A

Cholesterol
Ca+
Bilirubin

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3
Q

Most common type of gallstone?

A

Cholesterol stone

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4
Q

Gallstone S/S

A

Generally asymptomatic
Biliary colic
RUQ pain to R shoulder
May occur after ingestion of fatty foods.

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5
Q

5 F’s of gallstones

A 
Female
Forty
Fat
Fertile
Flatulence
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6
Q

Gallstone tx

A

Observation

Cholecystectomy

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7
Q

Gallstone protective factors

A 
Statins
Ascorbic acid
Coffee
Vegetable protein
Unsaturated fats
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8
Q

Choledocholithiasis

A

Presence of gallstones in the cystic bile duct.

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9
Q

Choledocholithiasis S/S

A

RUQ pain
Epigastric pain
N/V
ALT, AST elevated

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10
Q

ERCP

A

Endoscopic Retrograde Cholangiopancreatography.

Gold standard for dx and tx of Choledocholithiasis.

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11
Q

Acute cholecystitis

A

Gall bladder inflammation
90% caused by impacted gallstone.
10% by bile stasis.

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12
Q

Acute cholecystitis S/S

A

Murphys sign
RUQ pain
Fever
Leukocytosis

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13
Q

Cholescintigraphy

A

HIDA scan

FUnctional assesment of the hepatobiliary tree

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14
Q

Slow uptake in HIDA scan

A

Hepatic parenchymal dz

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15
Q

Non-visualization of GB w/ filling of CBD and duodenum =

A

Cystic duct obstruction and acute cystitis.

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16
Q

Acute cholecystitis tx

A

Admit, NPP, IV fluids and analgesia,.
Abx (cipro, flagyl)
Surgery

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17
Q

Emphysematous Cholecystitis

A

Rare form of cholecystitis
Air in GB wall from anaerobes
Men > women
50 - 70 yrs

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18
Q

Chronic cholecystitis

A

Occurs after repeated mild attacks.
Usually due to stones
Shrinking, scarring, thickening, fibrosis

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19
Q

Chronic cholecystitis S/S

A

intermittent RUQ pain that subsides in 30 mins.

Variable intervals, days to years

20
Q

Chronic cholecystitis tx

A

Surgical removal

21
Q

Porcelain Gallbladder

A

Extensive calcification of GB
Blue discoloration of GB wall at surgery.
Usually found incidentally

22
Q

Porcelain gallbladder is associated with?

A

GB adenocarcinoma

Should be removed.

23
Q

Cholangitis

A

Inflammation of bile duct system.
Usually bacterial, bugs ascend from duedenum.
Usually secondary to biliary obstruction

24
Q

Charcot’s Triad

A

For Cholangitis
RUQ Pain
Jaundice
Fever and chills

25
Q

Septic Cholangitis

A

Severe complication.

50% mortality

26
Q

Cholangitis Tx

A

Admit
IV Abx
ERCP
Blood cultures

27
Q

Primary Sclerosing Cholangitis

A

Diffuse biliary tract inflamation
Fibrosis, strictures develop
Can lead to cirrhosis
Men 20-40

28
Q

Primary sclerosing Cholangitis is associated with?

A

Ulcerative colitis

29
Q

Primary Sclerosing Cholangitis Presentation

A 
Progressive jaundice
Malaise, fatigue, anorexia
Cirrhosis, portal htn
ELevated alk phos, ALT, AST
ANCA
30
Q

Primary Sclerosing Cholangitis Tx

A

Stenting may help

Liver transplant

31
Q

Primary Biliary Cirrhosis (PBC)

A

Slowly progressive autoimmune liver dz
Destruction of intrahepatic bile ducts
Leads to cirrhosis and failure

32
Q

PBC is mostly males or females?

A

Females (90%) in their 40’s

33
Q

Which antibody do PBC patients have?

A

AMA (antimitochondrial antibody)

34
Q

PBC S/S

A 
50% asymptomatic
*Fatigue and pruritis*
Hyperpigmentation
Portal htn
Hepatomegaly
35
Q

PBC dx

A

Need 2-3 of:
Positive AMA
Abnormal LFT (esp alk phos, GGTP)
Biopsy shows interlobular destruction

36
Q

PBC Tx

A 
Ursodeoxycholic acid (UDCA) (Ursodiol)
Reduces risk for liver transplant
37
Q

Cholangiocarcinoma

A

Rare bile duct cancer
Blockage causes sx
Usually inoperable

38
Q

Chonalgiocarcinoma S/S

A

RUQ pain
Progressive jaundice
Anorexia, weight loss, fever
CA 19.9

39
Q

Cholangiocarcinoma prognosis

A

Less than 6 months for unrecectable cases.

40
Q

Gallbladder CA

A

Rare, highly fatal.
Gallstones are risk factor
Porcelain gallbladder is risk

41
Q

Ampulla of vater CA

A

Cancer of older age
Obstructive jaundice
+ FOBT
Whipple to tx

42
Q

UGT1A1 Gene

A

Defects in this gene can cause decreased clearance of bilirubin leading to jaundice
Gilberts syndrome

43
Q

Gilberts syndrome

A

Most common hereditary cause of increased bilirubin
Generally benign
Mild jaundice may occur
5-10% of pop

44
Q

Gilberts syndrome labs

A 
Elevated unconjugated (indirect) bilirubin
Everything else normal
45
Q

Which bilirubin is elevated in Gilberts again?

A

Unconjugated (indirect) bilirubin

46
Q

ANCA antibody is associated with?

A

Primary sclerosing cholangitis

Gastroenterology (14 decks)

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