gallbladder (W4)

Question 1

cholethias

Answer 1

gallstones in GB

Question 2

etiology

Answer 2

unknown

Question 3

RF

Answer 3

gender
age
estrogen
lifestyle- obese/sednentary
diet
family history

Question 4

where is bile produced?

Answer 4

liver

Question 5

where is bile stored?

Answer 5

gallbladder

Question 6

patho of cholethias

Answer 6

bile stasis
super saturated with cholesterol
precipitation

Question 7

small stone

Answer 7

pass through to bile duct, pain/obstruction/cholecystitis

Question 8

where is gallbladder located?

Answer 8

RUQ

Question 9

s/s of cholelithias

Answer 9

silent- think small/not moving
severity- move/obstruction
billary collic

Question 10

what is a billary collic

Answer 10

pain in RUQ that may radiate to shoulder
fatty meal, about 6 hours after
with steady severe pain

Question 11

manifestations of cholithias

Answer 11

jaundice
dark amber urine that foams when shaken
clay stool
steatorrhea
pruritis
intolerance of fatty foods
bleeding tendencies

Question 12

why does jaundice occur

Answer 12

bile cannot flow to duodenum

Question 13

why does dark amber urine that foams when shaken occur

Answer 13

soluble bilirubin in urine

Question 14

why does clay stool occur

Answer 14

bilirubin does not reach the small intestine

Question 15

why does steatorrhea occur

Answer 15

fatty stool because no bile salts in duodenum to digest fat

Question 16

why doe pruritis occur

Answer 16

deposit of bile in skin

Question 17

why does intolerance of fatty foods occur

Answer 17

no bile in small intestine to aid with digestion

Question 18

why do bleeding tendencies occur

Answer 18

decrease absorption of vitamin K

Question 19

gallstones form as a result of

Answer 19

abnormal accumulation of bile salts and other substances- cholesterol!

Question 20

cholecystitis

Answer 20

most common cause is the obstruction from gallstones/biliary sludge
other causes: prolonged immobility, fasting, bacterial infection, parental nutrition, DM

Question 21

cholecystitis pathogenesis

Answer 21

obstruction- inflammation

gallbladder becomes: edematous, hyperemic, distended

Question 22

cholecystitis over time

Answer 22

scarring and decreased functioning (eventually ineffective- removal)

Question 23

cholecystitis manifestations

Answer 23

similar s/s to cholelithiasis
bc of inflammation component: fever, n/v, restlessness, diaphoresis
lab values: bilirubin, liver enzymes, WBC, amylase (pancreatic enzyme)
can lead to peritonitis- infection in site that is suppose to be sterile

Question 24

analgesic (ketoralac/morphine)

Answer 24

pain control

Question 25

antiemetics

Answer 25

nausea and vommitting

Question 26

anticholinergics

Answer 26

to decrease gallbladder secretions and stop smooth muscle spasms

Question 27

bile acids (rarely used)

Answer 27

dissolves stones

Question 28

most gallstones are composed of

Answer 28

cholesterol