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Abdomen Pathology > Gallbladder Pathology > Flashcards

Gallbladder Pathology Flashcards

1
Q

What is the most common cause of gallbladder wall thickening?

A

cholecystitis

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2
Q

Causes of gallbladder wall thickening

A

cholecystitis, adenomyomatosis, cancer, AIDS/HIV

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3
Q

Pericholecystic fluid is seen with?

A

acute cholecystitis

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4
Q

Gallbladder pathology is due to?

A

metabolic factors, stasis, inflammation

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5
Q

Choledochal cyst

A

outpouching of ductal walls due to relfuxing of enzymes

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6
Q

What is the most common form of a choledochal cyst?

A

fusiform dilatation of the CBD

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7
Q

Choledochal cyst type V is also known as?

A

Caroli’s Disease

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8
Q

Caroli’s disease

A

nonobstructive saccular dilatation of intrahepatic ducts

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9
Q

Caroli’s disease is more common in?

A

adults

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10
Q

Signs and symptoms of Caroli’s disease

A

jaundice, displacement of stomach and duodenum

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11
Q

Choledochal cysts are more common in?

A

children

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12
Q

Sludge

A

bile that coagulates; can lead to stones

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13
Q

Signs and symptoms of sludge

A

RUQ pain

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14
Q

What is the main cause of sludge?

A

prolonged fasting

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15
Q

Sonographic appearance of sludge

A

tends to layer, low level echoes, viscous, mobile, no shadow

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16
Q

Tumefactive sludge give the appearance of a?

A

pseudotumor

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17
Q

Sonographic appearance of tumefactive sludge

A

does not layer, sludge balls, mobile, echogenic, non shadowing

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18
Q

Sonographic appearance of cholelithiasis

A

mobile, echogenic foci, shadowing, gravity dependant

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19
Q

Which lab value is elevated with cholelithiasis?

A

ALP

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20
Q

6 Fs of cholelithiasis

A

Fat, Female, Fair, Forty, Fertile, Flatulent

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21
Q

WES sign

A

wall, echogenicity, shadow; gallbladder full of stones

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22
Q

With the WES sign, which part of the lumen is seen?

A

anterior

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23
Q

Bile duct obstruction causes an elevation in which lab values?

A

bilirubin and ALP

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24
Q

Signs and symptoms of bile duct obstruction

A

RUQ pain, jaundice, fever

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25
Q

Bile duct obstruction causes what sign?

A

double barrel, double duct

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26
Q

Choledocholithiasis can lead to?

A

cholangitis

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27
Q

Choledocholithiaisis causes an elevation in which lab values?

A

direct bilirubin, ALP, transaminase

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28
Q

The CBD is considered enlarged when it measures larger than?

A

7 mm

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29
Q

What is the most common inflammatory condition of the gallbladder?

A

acute cholecystitis

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30
Q

Signs and symptoms of acute cholecystitis

A

positive Murphy’s sign, RUQ pain, nausea, vomiting, fever

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31
Q

What lab values are elevated with acute cholesystitis?

A

ALP, leukocytosis, hyperbilirubinemia

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32
Q

Sonographic appearance of acute cholecystitis

A

wall thickening, enlarged gallbladder, may have stones, pericholecystic fluid, hyperemia

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33
Q

Acute acalculous cholecystitis

A

acute cholecystitis with no stones

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34
Q

Signs and symptoms of AAC

A

RUQ pain, positive Murphy’s sign, nausea, vomiting

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35
Q

Sonographic appearance of AAC

A

enlarged gallbladder with wall thickening, pericholecystic fluid

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36
Q

Empyema is also called?

A

Suppurative cholecystitis

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37
Q

Suppurative cholecystitis

A

pus in gallbladder

38
Q

Empyema is more common in?

39
Q

Signs and symptoms of empyema

A

RUQ pain, fever, chills

40
Q

Empyema can resemble?

41
Q

Gallbladder perforation can result from?

A

acute cholecystitis

42
Q

Gallbladder perforation usually occurs in which portion?

43
Q

Signs and symptoms of gallbladder perforation

A

RUQ pain, vomiting, fever, leukocytosis, abnormal LFTs

44
Q

Sonographic appearance of gallbladder perforation

A

defect in wall, complex fluid collection, irregular wall

45
Q

Gangrenous cholecystitis

A

ischemic or necrotic wall due to lack of blood flow or infection

46
Q

What kind of patients are more at risk for gangrenous cholecystitis?

47
Q

Sonographic appearance of gangrenous cholecystitis

A

thick irregular wall, gas or air in wall or lumen, ring down artifact

48
Q

Emphysematous cholecystitis

A

gas in wall, lumen, pericholecystic space, or ducts from bacteria

49
Q

Which patients are more at risk for emphysematous gallbladder?

A

men; diabetics

50
Q

Sonographic appearance of emphysematous cholecystitis

A

gas appears as echogenic foci in wall or lumen, mobile, non gravity dependant, ring down or comet tail

51
Q

Chronic cholecystitis is more common in?

A

women; elderly

52
Q

What lab values are elevated with chronic cholecystitis?

A

ALP, AST, ALT, and bilirubin if jaundiced

53
Q

Sonographic appearance of chronic cholecystitis

A

wall thickening, small gallbladder, cholelithiaiss

54
Q

Bouveret syndrome

A

stones goes through gallbladder and into duodenum

55
Q

Mirizzi syndrome

A

stone in cystic duct or neck causing compression on adjacent duct

56
Q

Jaundice is also called?

57
Q

Porcelain gallbladder

A

wall is calcified due to extensive inflammation

58
Q

Porcelain gallbladder can lead to?

59
Q

Porcelain gallbladder is more common in?

A

elderly women

60
Q

Sonographic appearance of porcelain gallbladder

A

echogenic line with acoustic shadowing obscuring the gallbladder; gallstones are usually present

61
Q

With dilated intrahepatic ducts, the obstruction is always ______ to the obstruction

62
Q

Radicals cause an increase in which lab value?

63
Q

Cholesterol polyp

A

benign growth of cholesterol

64
Q

Sonographic appearance of a polyp

A

echogenic, fixed, no shadow, stalk

65
Q

Differenc between adenoma and polyp

A

adenoma has no stalk

66
Q

Primary gallbladder carcinoma begins as?

A

polyp, porcelain gallbladder, or chronic cholecystitis

67
Q

Gallbladder carcinoma can be caused by METS from?

A

pancreatic cancer

68
Q

Adenomyomatosis

A

excessive proliferations of surface epithelium with diverticula or outpouchings into lumen

69
Q

Adenomyomatosis is also called?

A

Rokitansky-Aschoff sinuses

70
Q

Adenomyomatosis is more common in?

71
Q

Sonographic appearance of adenomyomatosis

A

comet tail with twinkle artifact; zig zag stripes, wall thickening

72
Q

Strawberry gallbladder is also called?

A

cholesterolosis

73
Q

Cholesterolosis

A

abnormal cholesterol deposits in wall; associated with gallstones

74
Q

Strawberry gallbladder is more common in?

75
Q

Sonographic appearance of cholesterolosis

A

fixed, no shadow, echogenic foci (seeds)

76
Q

Courvousier gallbladder

A

palpable,enlarged, nontender, gallbladder in a jaundiced patient

77
Q

Courvousier gallbladder is caused by?

A

extrinsic compression of CBD

78
Q

Most common cause of Courvousier gallbladder

A

mass at pancreatic head

79
Q

Hydropic gallbladder

A

abnormally distended gallbladder

80
Q

Most common cause of hydropic gallbladder

A

stone in neck or cystic duct

81
Q

Sonographic appearance of a hydropic gallbladder

A

round, distended, thin wall

82
Q

Cholangiocarcinoma

A

primary malignancy in bile ducts

83
Q

Klatskin tumor is a type of?

A

cholangiocarcinoma

84
Q

Klatskin tumors cause dilation of the?

A

intrahepatic ducts

85
Q

Klatskin tumors are located where?

A

at the junction of the right and left intrahepatic duct

86
Q

Signs and symptoms of cholangiocarcinoma

A

icterus, palpable gallbladder, anorexia, fatigue

87
Q

Cholangitis

A

inflammation or fibrosis of the ducts

88
Q

Cholangitis causes an increase in which lab values?

A

ALP, AST, ALT, leukocytosis, and direct bilirubin with jaundice

89
Q

Pneumobilia

A

gas/air in biliary tree; caused by surgery or infection

90
Q

Pneumobilia causes what artifact?

A

dirty shadowing

92
Q

Which type of gallbladder perforation is more common? What forms with it?

A

subacute; abscess

Abdomen Pathology (6 decks)

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