gallstones

Question 1

define gallstones?

Answer 1

• stone formation in the gallbladder

Question 2

what are the types of gallstones?

Answer 2

• mixed stones
• pure cholesterol stones
• pigment stones

Question 3

what do mixed stones contain and what are the risk factors?

Answer 3

• cholestrol
• calcium bilirubinate
• phosphate and protein
• associated with older age, obese, female, paraenteral nutrition, drugs, family history, pima indians (ethnicity), crohns, terminal ileal resection

Question 4

what do pure pigment stones contain and what are the risk factors?

Answer 4

only cholesterol

• same associations as mixed

Question 5

what do pigment stones contain and what are the risk factors?

Answer 5

• these are black stones made by calcium bilirubinate
• or brown stones due to bile duct infestation
• they are associated with haemolytic conditions

Question 6

epidemiology of gallstones in the UK?

Answer 6

• very common in the UK
• more common with age
• more common in young females
• 50:50 in older people

Question 7

what are the 3 main presentations of gallstones?

Answer 7

• biliary colic
• acute cholecystitis
• ascending cholangitis

Question 8

symptoms of biliary colic?

Answer 8

• sudden onset pain
• right upper quadrant
• associated with vomiting
• constant in nature

Question 9

symptoms of acute cholecystitis?

Answer 9

inflammation of the gallbladder

• patient is systemically unwell
• upper Abdo pain referred to the right shoulder

Question 10

symptoms of ascending cholangitis?

Answer 10

infection of the bile duct 
charcots triad 
- right upper quadrant pain
- jaundice 
- rigors 

if combined with hypotension and confusion it is Reynolds pentad