Gallbladder disorders: Pathology review Flashcards

1
Q

What hormone is responsible for gallbladder contractions ?

A

Cholicystokinenin released in response to fatty food by the enteroendocrine cells.

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2
Q

What is the most common type of gall stone ?

A

cholesterol stone. That are yellow in color and radiolucent ( can;t be seen on X-ray).

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3
Q

What are the 4 F’s of cholesterol gallstone risk factors ?

A

Female, fertile, fat and 40

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4
Q

How does fibrates cause cholesterol gallstones ?

A

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.

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5
Q

What are the risk factors for radio opace calcium billirubinate gallstones ?

A

Conditions that can cause extra-vascular hemolysis such as Sickle cell disease, Hereditary spherocytosis, and beta thalasemia.

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6
Q

What is the color of billirubinate calcium gallstones ?

A

Black.

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7
Q

What are the causes of brown pigmented gallstones stones ?

A

billiary infections by organism such as E.colli, Ascaris lumbricoids, and clonroches sinanes. It is often asymptomatic. therefore it does not require any intervention.

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8
Q

what is the non-surgical option for symptomatic cholelethiasis ?

A

Ursodeoxycholic acid.

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9
Q

What is Boas sign ?

A

The pain in acute cholecystitis radiating to the right shoulder.

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10
Q

What is Murphy’s sign ?

A

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.

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11
Q

What are the laboratory findings in acute cholecystitis ?

A

Increased ALP, WBC and CRP.

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12
Q

What is the modality of choice when US is inconcluisve in acute cholecystitis ?

A

HIDA scan.

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13
Q

What are the elements of Rigler’s triad in gallstone illius ?

A
  • Pneumobilia
  • SBO
  • Gallstone outside gallbladder.
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14
Q

What is Rockitansky-Aschoff sign ?

A

It is the invagination of gallblader mucossa into the gallbladder muscle wall seen in chronic cholecystitis.

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15
Q

What is Porcelline gallbladder ?

A

It is calcified gallblader seen in chronic cholicystitis.

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16
Q

What is the risk of Porcelline gallbladder ?

A

It has increased risk of causing adenocarcinoma of the gallbladder and has a very poor surivial rate.

17
Q

What are the laboratory findings in choledocholelithiasis ?

A

Increased serum conjugated billirubin, increased GGT, ALP, ALT and AST.

18
Q

What are the elements of Charcot’s triad in ascending cholangitis ?

A

Fever, RUQ pain, and Jaundice. If there is hypotension and confusion it is called Raynolds pentad.

19
Q

What is the therapeutic utility diffrence b/s ERCP vs MRCP ?

A

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.

20
Q
A