Gastroenterology

Question 1

Cholesterol Gallstones

Answer 1

-more common (75%)
-older, female, Native American, western diet, pregnancy, obesity, estrogen supplements, TPN

Question 2

Pigment Gallstones

Answer 2

-chronic hemolysis
-ineffective erythropoiesis
-Crohn disease
-bacterial biliary infection
-cirrhosis
-biliary stasis

Question 3

Indications for Cholecystectomy in Asymptomatic Patients

Answer 3

-Porcelain gall bladder
-Stones >3cm
-Polyps >1cm
high risk for gall bladder cancer

Question 4

Biliary Colic

Answer 4

-lasts 30 min - 6 hours
-RUQ or epigastric
-after food
-should undergo cholecystectomy

Question 5

Acute Cholecystitis

Answer 5

-cystic duct obstruction, gall bladder inflammation
-positive Murphy sign
-gall bladder edema on US
-treatment with antibiotics (gram negative, anaerobes), cholecystectomy during hospitalization