Gallbladder disorders: Pathology review Flashcards
What hormone is responsible for gallbladder contractions ?
Cholicystokinenin released in response to fatty food by the enteroendocrine cells.
What is the most common type of gall stone ?
cholesterol stone. That are yellow in color and radiolucent ( can;t be seen on X-ray).
What are the 4 F’s of cholesterol gallstone risk factors ?
Female, fertile, fat and 40
How does fibrates cause cholesterol gallstones ?
They act by inhibiting the enzyme Cholesterol 7 alpha hydroxylase an enzyme responsible for the synthesis of bile acids. inhibition of it leads to cholesterol gallstone.
What are the risk factors for radio opace calcium billirubinate gallstones ?
Conditions that can cause extra-vascular hemolysis such as Sickle cell disease, Hereditary spherocytosis, and beta thalasemia.
What is the color of billirubinate calcium gallstones ?
Black.
What are the causes of brown pigmented gallstones stones ?
billiary infections by organism such as E.colli, Ascaris lumbricoids, and clonroches sinanes. It is often asymptomatic. therefore it does not require any intervention.
what is the non-surgical option for symptomatic cholelethiasis ?
Ursodeoxycholic acid.
What is Boas sign ?
The pain in acute cholecystitis radiating to the right shoulder.
What is Murphy’s sign ?
It is the pain and apnea experienced by a patient with cholecystitis while palpating the RUQ at the intersection of midd clavicular line and trans pyloric plane.
What are the laboratory findings in acute cholecystitis ?
Increased ALP, WBC and CRP.
What is the modality of choice when US is inconcluisve in acute cholecystitis ?
HIDA scan.
What are the elements of Rigler’s triad in gallstone illius ?
- Pneumobilia
- SBO
- Gallstone outside gallbladder.
What is Rockitansky-Aschoff sign ?
It is the invagination of gallblader mucossa into the gallbladder muscle wall seen in chronic cholecystitis.
What is Porcelline gallbladder ?
It is calcified gallblader seen in chronic cholicystitis.
What is the risk of Porcelline gallbladder ?
It has increased risk of causing adenocarcinoma of the gallbladder and has a very poor surivial rate.
What are the laboratory findings in choledocholelithiasis ?
Increased serum conjugated billirubin, increased GGT, ALP, ALT and AST.
What are the elements of Charcot’s triad in ascending cholangitis ?
Fever, RUQ pain, and Jaundice. If there is hypotension and confusion it is called Raynolds pentad.
What is the therapeutic utility diffrence b/s ERCP vs MRCP ?
ERCP is X-ray based it can be used to visualize and remove obstructions in the billiary tree. However, MRCP can only be used for visualization.
