Gallbladder & Pancreas Pathology Flashcards
What is a cholelithiasis?
Gall stone
In industrialized nations, 75% of gallstones are ____
Cholesterol based/unpigmented
Cholesterol based gall stones are ____
Unpigmented
Bile-salt based gall stones are ____
Pigmented
Pigmented or bile-salt gall stones are more common in what region?
Tropics
What is biliary colic?
- waxing and waning right upper quadrant pain (Murphy’s point)
- due to stone lodged in cystic duct
What point is associated with a gall stone and where is it located?
Murphy’s point in the RUQ of the abdomen
What are the four Fs of a cholelithiasis?
Female
Forty
Fat
Fertile
A 40 year old female patient named Samantha presents to your office complaining of right upper quadrant pain. She has 7 kids. She is 5’2 and weights 190 pounds which she blames on children number 4-7. A radiograph of the thoracolumbar region shows a bag of jewels in the right upper quadrant. What is the likely diagnosis?
Cholelithiasis
What is a choledocholithiasis?
Gallstone in the common bile duct
What is acute cholecystitis?
Acute inflammation of the gall bladder wall
What is the pathogenesis of acute cholecystitis?
Impacted stone in the cystic duct results in dilation with pressure ischemia
What are the clinical features of acute cholecystitis?
- RUQ pain, often radiating to R scap
- fever
- ^WBC
- nausea, vomiting
- risk of rupture if untreated
35 year old female patient presents to your office with upper right quadrant pain and right shoulder pain on the back of her right scapula. She is febrile and nauseous. A CBC shows 82% neutrophils and 14,000 WBCs. What is the likely diagnosis?
Acute cholecystitis
Porcelain gallbladder is a late complication of what pathology?
Chronic cholecystitis
What is porcelain gallbladder and what can it lead to?
- shrunken, hard gallbladder due to chronic inflammation, fibrosis, & dystrophic Ca.
- may lead to cholangio adenocarcinoma (cancer of gallbladder)
What are the clinical features of chronic cholecystitis?
- Hx of longstanding cholelithiasis w/ or w/out superimposed bouts of acute cholecystitis
- vague RUQ pain, especially after eating
56 year old female patient presents to your office complaining of diffuse upper right quadrant pain that comes and goes. When asked what bring on the pain she is not positive but notes that it does get worse after she eats. Radiograph of the thoracolumbar region reveals fibrosis and dystrophic calcification present on the quadrate lobe (inferior surface) of the liver. What is the likely diagnosis?
Chronic cholecystitis
What are the etiologies of acute pancreatitis?
Ethanol and duct obstruction
How does duct obstruction cause acute pancreatitis?
Reflux of enzymes into the pancreas from the major duodenal papilla being obstructed