Gallstones

Question 1

What are the 6 Fs RFs associated with gallstone formation?

Answer 1

Fat
Female
Fertile
Flatulence
Forty
Fair

Question 2

Why do gallstones form?

Answer 2

Imbalance in the composition of bile

Question 3

Explain cholesterol gallstones

Answer 3

made when there is excess cholesterol
1. bile is supersaturated with cholesterol ➔ creates stones
2. bile does not have enough salts and acids to emulsify the cholesterol
3. Bile stasis ➔ bile isn’t moving so the cholesterol is precipitated out

not visible on xray

Question 4

What is the composition of bile?

Answer 4

Bile is made of
1. cholesterol
2. bile salts (acids)
3. bile pigments
4. electrolytes
5. other fats

Question 5

explain pigmented gallstones

Answer 5

typically when there is a build-up of unconjugated bilirubin ➔ extravascular hemolysis

visible on x ray because the gallstones are made of unconjugated bili + calcium and calcium makes it visible

Question 6

explain brown gallstones

Answer 6

sign of infection

Calcium + unconjugated bilirubin + hydrolyzed phospholipids (by an infection like E. coli or roundworm)

more seen in asian populations because of the liver fluke parasite which can be one source of infection