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COMAT - Surgery > Gallstone Diseases > Flashcards

Gallstone Diseases Flashcards

1
Q

What is the most common type of gallstone made of?

A

Cholesterol

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2
Q

What is the most common color of gallstones?

A

Green - cholesterol

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3
Q

Who is at risk for gallstones made of cholesterol?

A

Female
Fat
Forty
Fertile

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4
Q

What is a lesser common type of gallstone made of?

A

Bilirubin

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5
Q

What is the color of a less common type of gallstone?

A

Black - bilirubin

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6
Q

What causes someone to have gallstones made of bilirubin?

A

Hemolysis
– Can occur in kids

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7
Q

Choledocholithiasis

A

Stone stuck in the common bile duct or pancreatic duct

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8
Q

How will the gallbladder look with choledocholithiasis?

A

Mostly unaffected but will possibly have stones within it

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9
Q

How will the common bile duct look with choledocholithiasis?

A

It will be dilated proximal to the stone

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10
Q

What is a sign a stone is stuck somewhere in the common bile duct/pancreatic duct that will not be present if the stone was stuck elsewhere?

A

JAUNDICE

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11
Q

What lab changes will be present with Choledocholithiasis?

A

HIGH Alk Phos and Bilirubin
+/- HIGH LFTs

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12
Q

What is the first diagnostic test for RUQ pain?

A

RUQ Ultrasound

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13
Q

Following an ultrasound, what is the order of things that should be done for Choledocholithiasis and related disorders? (3)

A
  • MRCP
  • ERCP
  • Cholecystectomy
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14
Q

What is Ascending Cholangitis?

A

Choledocholithiasis + INFECTION of the biliary tree

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15
Q

Stone stuck in the common bile duct + infection of the biliary tree

A

Ascending Cholangitis

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16
Q

What is the Triad of symptoms that can present with Ascending Cholangitis?

A

RUQ pain
Fever
Jaundice

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17
Q

What is the Pentad of symptoms that can present with Ascending Cholangitis?

A

RUQ pain
Fever
Jaundice
Altered mental status
Hypotension

18
Q

If you suspect Ascending Cholangitis, what diagnostics/treatment should you do?

A

SKIP the MRCP
–> ERCP, Cholecystectomy, ABx

19
Q

What is Gallstone Pancreatitis?

A

Choledocholithiasis with stone stuck in the pancreatic duct + PANCREATITIS

20
Q

What lab change will point you toward Gallstone Pancreatitis?

A

HIGH Lipase 3X upper limit of normal

21
Q

For Gallstone Pancreatitis and Choledocholithiasis, what is the order of diagnostic tests/treatment that should be done?

A
  1. RUQ US
  2. MCRP
  3. ERCP
  4. Cholecystectomy
22
Q

For Choledocholithiasis, Gallstone Pancreatitis and Ascending Cholangitis, what lab changes are commonly present?

A

HIGH Alk phos and Bilirubin
+/- HIGH LFTs/Lipase

23
Q

Where is the stone stuck with Acute Calculous Cholecystitis?

A

Cystic Duct

24
Q

Is the common bile duct affected with Acute Cholecystitis?

A

NO – just the gallbladder

25
Q

Will jaundice be present with Acute Cholecystitis?

A

NO

26
Q

Following a (-) RUQ US, what diagnostic test should be done for Acute Calculous Cholecystitis?

A

HIDA scan

27
Q

What classifies a (+) HIDA scan?

A

Inability for tracer to enter the gallbladder

28
Q

What 3 things will be seen on RUQ Ultrasound with Acute Calculous Cholecystitis?

A
  1. Gallstones
  2. Pericholecystic fluid
  3. Gallbadder wall thickening
29
Q

In what patients does Acute Acalculous Cholecystitis occur?

A

Critically ill - receiving parental nutrition

30
Q

What will be seen on RUQ ultrasound with Acute Acalculous cholecystitis?

A
  1. Pericholecystic fluid
  2. Gallbladder wall thickening
31
Q

What is the treatment for Acute Calculous Cholecystitis? Acalcuous?

A

Calculous = Cholecystectomy + ABx
Acalcuous = Percutaneous Drain

32
Q

What is Biliary Colic?

A

Symptomatic Cholelithiasis

33
Q

Cholelithiasis

A

Gallstones in the gallbladder

34
Q

What type of symptoms will be present with Biliary Colic?

A

RUQ pain that is worse after eating and fatty foods – episodic

35
Q

What will be seen on RUQ ultrasound with Biliary Colic?

A

Gallstones ONLY

36
Q

How does a Gallstone Ileus arise?

A

Gallstone passes through a biliary-enteric fistula

37
Q

Where often is the obstruction with a Gallstone Ileus?

A

Gallstone lodges in the Ileum

38
Q

Signs of a Gallstone Ileus?

A

BOWEL OBSTRUCTION
= Abdominal distention, N/V, constipation and pain

39
Q

What will a CT scan show with Gallstone Ileus?

A

AIR in the BILIARY TREE
– dilated bowel/obstructing stone too

40
Q

What will a CT scan show with Gallstone Ileus?

A

AIR in the BILIARY TREE
– dilated bowel/obstructing stone too

41
Q

Common choice of antibiotic treatment for Acute Cholecystitis?

A

Piperacillin-Tazobactam

COMAT - Surgery (13 decks)

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