Gallbladder pancreas Flashcards

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1
Q

Nerve supply of gallbladder

A

T8 and T9 (epigastric)

Vagus and sympa

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2
Q

How much bile formed per day

A

500-1000 ml

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3
Q

CCK action to gallbladder and sphincter of oddi?

A

GB Contraction

Sphincter of Oddi relaxation

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4
Q

Diagnostic studies for proximal and distal biliary ducts respectively:

A

Proximal bile duct: PTC (percutaneous transhepatic cholangiography)

Distal bile duct: ERCP

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5
Q

Sonographic signs of acute cholecystitis:

A

Gallbladder thickening
Pericholecystic fluid
Sonographic murphy’s

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6
Q

Most common type of gallstone

A

Cholesterol type

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7
Q

Gallstone type: SINGLE, large smooth

A

Pure cholesterol

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8
Q

Gallstone type: MULTIPLE, multifaceted “mulberry shaped”

A

Mixed type (>70% cholesterol)

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9
Q

Gallstone type: small brittle spiculated, calcium bilirubinate, carbonate and phosphate
Due to HEMOLYSIS and CIRRHOSIS

A

Black pigment stones

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10
Q

Gallstone type: soft and mushy, only stone that can arise from the bile ducts
Due to BACTERIAL INFXN or BILE STASIS

A

Brown pigment stones

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11
Q

Characterized by recurrent biliary colic and due to partial obstruction of the cystic duct

A

Chronic cholecystitis

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12
Q

Initiating event of acute checystitis

A

Obstruction of cystic duct

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13
Q

Cystic artery is a branch of

A

Right hepatic artery

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14
Q

Most specific test for gallstone

A

HIDA scan

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15
Q

Gold standard diagnostic test for chiledocholithiasis

A

ERCP

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16
Q

Two combination for cholangitis to occur

A
Bacterial contamination (gram negative aerobes)
Obstruction
17
Q

What is charcot’s triad?

A

Fever
Pain
Jaundice

18
Q

Reynold’s pentad

A
Fever
Pain
Jaundice
Disorientation
Septoc shock
19
Q

Most common form of choledochal cyst

A

Fusiform

20
Q

Triad of choledochal cyst

A

Abdominal pain
Jaundice
Mass

21
Q

Choledochal cyst in intrahepatic ducts

A

CAROLI’s disease

Tx: liver transplant

22
Q

May develop to form cholangiocarcinoma

Most common in men

A

Primary Sclerosing Cholangitis

23
Q

2 liver disease that requires liver transplantation

A

Primary sclerosing cholangitis

CAROLI’s disease

24
Q

Treatment of gallbladder CA with extension to perimuscular connective tissue (T2)

A
Extended cholecystectomy
Liver resection (4a and 5)
25
Q

Treatment of gallbladder CA with extension beyond serosa

A
Extended right hepatectomy 
Liver resection (4 to 8)
26
Q

Most common presentation of bile duct carcinoma

A

Painless jaudice

27
Q

Tumor marker for bile duct carcinoma

A

CA 19-9

CA 125 CEA

28
Q

Most common congenital anomaly

Functional obstruction of duct of santorini

A

Pancreas Divisum

29
Q

2nd part if duodenum surrounded by a rim of pancreatic tissue
May cause proximal small intestinal obstruction

A

Annular pancreas

30
Q

Flank ecchymosis

A

Grey turner’s sign

31
Q

Periumbilical ecchymosis

A

Cullen’s sign

32
Q

Ranson’s prognostic signs

At admission

A
Age >55 years old
Wbc count
FBS
LDH
SGOT
33
Q

Ranson’s prognostic signs

Initial 48 hours

A
Hct
Elevated BUN
serum Ca
PO2
Base deficit
Fluid deficit