Gallstones

Question 1

What causes gallstones?

Answer 1

bile salts and cholesterol combine and cause stones usually due to excess cholesterol

Question 2

What are the signs of gallstones?

Answer 2

Bilary colic - stone is stuck, worse after eating (Cholescystokinin - causes contraction of gallbladder)
Jaundice - if blocking bile duct
High temp and tachycardia if bile duct is blocked
Murphys sign

Question 3

What are the symptoms?

Answer 3

Nausea
Vomiting
Persistent Pain

Question 4

What is Murphy’s sign?

Answer 4

Patient is asked to inhale when the examiners fingers are at the inferior liver border.
This causes the gallbladder to descend onto the examiners fingers producing pain if the gallbladder is inflamed.

Question 5

What are the risk factors for gallbladder disease?

Answer 5

Female
Obese 
Age
Multiparity 
Poor diet
OCP 
Ileal disease 
haemolytic disease

Question 6

How is gallstones treated?

Answer 6

Laproscopic surgery to remove bladder

Low fat diet

Question 7

Which structures does the bile pass through?

Answer 7

Cystic duct –> common bile duct –> ampulla de vater –> major duodenal papilla

Question 8

What would be the blood test results in a patient with gallstones obstructing the bile duct?

Answer 8

Increased bilirubin
Increased ALP
ALT/AST ratio may be increased
Dark urine - bilirubin in urine