Gallbladder Quiz 5

Question 1

Congenital biliary atresia

Answer 1

common bile duct is blocked or terminates/is absent

see liver sx in children such as itching, malabsorption, eventual cirrhosis and portal HTN.

Question 2

choledocal cysts

Answer 2

congenital cystic dilations of common bile duct

Question 3

cholelithiasis

Answer 3

stones in gallbladder, bile duct, pancreatic duct, ampulla

Question 4

choledocolithiasis

Answer 4

stones in common bile duct

Question 5

what causes more of a risk cholelithiasis or choledocolithiasis? And why?

Answer 5

choledocolithiasis because the stones can block the liver, gallbladder, and pancreas.

Question 6

when does acquired biliary atresia occur?

Answer 6

autoimmune disease and causes chronic rejection of transplanted liver allograft

Question 7

treatment for congenital biliary atresia?

Answer 7

surgical anastomosis or transplant

Question 8

what are sx of choldedocal cyst?

Answer 8

jaundice and clay colored stools

Question 9

what are the most common causes of cholecystitis?

Answer 9

escherichia coli

bacteroides

Question 10

what causes acute cholecystitis?

Answer 10

cholelithiasis: blockage of cystic duct

Question 11

cholesterol stones

Answer 11

>80% cholesterol by weight
most common (90% of all stones)

Question 12

pigment stones

Answer 12

< 20% cholesterol
show up on x-ray due to ca
small dark stones

Question 13

mixed stones

Answer 13

20-80% cholesterol

possibly visible on X-ray depending on ca level

Question 14

cholesterolosis

Answer 14

• abnormal deposition of cholesterol in gallbladder wall
• thickened wall
• cholesterol stones seen at times

Question 15

what is cholesterolosis associates with?

Answer 15

chronic cholecystitis

and sometimes cholelithiasis

Question 16

hist of cholesterolosis?

Answer 16

strawberry gallbladder

bright yellow dots on mucosal surface

Question 17

hist of chronic cholecystitis

Answer 17

Rokitansky-Aschoff sinuses in muscularis layer: pockets in wall of muscularis layer

Question 18

porcelain gallbladder

Answer 18

calcified by persistent inflammation due to presence of stones
- outlined in thin white ring on X-ray

Question 19

what is a concern with porcelain gallbladder?

Answer 19

gallbladder cancer

Question 20

what is a bad sequelae of choledocolithiasis?

Answer 20

risk of ascending cholangitis of bacteria in colon ascending to liver via ductal system

• life threatening
• happen more often in the presence of gallstones (70-90%)

Question 21

hist of ascending cholangitis

Answer 21

onion skin fibrosis of duct

- indistinguishable from that seen in PSC

Question 22

cholangitis

Answer 22

inflammation of duct

Question 23

what are risk factors for gallbladder carcinoma?

Answer 23

chronic cholecystitis
chronic cholelithiasis
obesity

Question 24

1 type of gallbladder cancer

Answer 24

adenocarcinoma

- glandular origin and malignant

Question 25

hist of gallbladder carcinoma

Answer 25

more mitotic figures

greater nucleus to cytoplasm ratio

Question 26

Risk factors for carcinoma of extra hepatic bile ducts

Answer 26

UC
choledocal cyst
parasites
gallstones

Question 27

what type of cells are seen in intestinal type andenocarcinoma of the gallbladder?

Answer 27

lots of goblet cells