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Hepatobiliary Flashcards

1
Q

What is another name for Gallstones?

A

Cholelithiasis

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2
Q

Cholelithiasis are abnormal calcifications located where?

A

In the Gallbladder and the Biliary Tree

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3
Q

What are two major types of stones?

A

Cholesterol and Pigment

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4
Q

Where are gallstones typically found?

A

RUQ

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5
Q

Who is at risk for developing Gallstones?

A
  • Women
  • The elderly
  • Diabetics
  • People over 40
  • Obese
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6
Q

At least ___ of people in the U.S will develop gallstones by the time they are 65.

A

20%

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7
Q

What is another name for an acute inflammation of the gallbladder?

A

Acute Cholecystitis

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8
Q

What is Acute cholecystitis?

A

An obstruction of the cystic duct by an impacted stone

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9
Q

Acute Cholecystitis is caused by an injury to the wall of the cystic duct, allowing _____ to enter.

A

Bacteria

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10
Q

In terms of acute Cholecystitis, bile accumulates within the Gallbladder, ______ the wall.

A

Irritating

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11
Q

What is a porcelain Gallbladder?

A

Thick walled Gallbladder that becomes calcified

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12
Q

What does the detection of extensive calcification in the wall of the gallbladder indicate?

A

The possibility of carcinoma

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13
Q

Although a porcelain gallbladder is uncommon in cases of carcinoma of the gallbladder, there is a striking incidence of _______ in patients with porcelain gallbladder. Up to ____ of the cases.

A

Carcinoma/ 60%

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14
Q

What % of the cases are acute cholecystitis?

A

95%

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15
Q

What type of stones in the U.S make up 75%?

A

Cholesterol

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16
Q

What is a fissure that produces the Mercedes Benz sign?

A

A non opaque stone containing gas filled fissures that produce the Mercedes Benz symbol

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17
Q

What is Emphysematous Cholecystitis?

A

An acute infection of the gallbladder; gas forming bacteria organism

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18
Q

What is a result of an acute infection of the gallbladder that produces a gas forming bacteria organism?

A

Emphysematous Cholecystitis

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19
Q

What causes Emphysematous Cholecystitis?

A
  • A cystic duct obstruction

- Air within lumen dissects into wall

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20
Q

Who does Emphysematous Cholecystitis most frequently occur in?

A
  • Elderly men

- Pt’s with poorly controlled diabetes

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21
Q

Is Emphysematous Cholecystitis a surgical emergency?

A

Yes

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22
Q

Porcelain Gallbladder refers to the extensive ________ in the ____ of the gallbladder, which forms an oval density that corresponds to the size and shape of the organ

A

Calcification/ wall

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23
Q

What does chronic Cholecystitis result in?

A
  • Loss of wall function

- Gallbladder becomes fibrotic and calcified

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24
Q

What color does porcelain gallbladder refer to?

A

Blue discoloration and brittle consistency

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25
What is a bilobed gallbladder?
Internal septum dividing into 2
26
What is an hourglass gallbladder?
Body is narrow in middle
27
What is a phrygian cap?
Fundus folds over body
28
What is a Choledochal cyst?
Cystic dilation of hepatic or bile ducts of liver
29
What is Hepatitis?
Inflammation of liver cells
30
What is the most prevalent inflammatory disease of the liver?
Hepatitis
31
Hepatitis is a ____ infection or reaction to drugs or toxins.
Viral
32
Are early stages of Hepatitis visible on diagnostic images?
No
33
What are some complications of Hepatitis?
- Jaundice - Cirrhosis - Hepatocellular carcinoma
34
What is Hepatitis A?
- Transmitted in digestive tract from oral/ fecal contact - Highly contagious - Favorable prognosis
35
What is Hepatitis B?
- Exposure to blood or blood products - Sexual contact - Healthcare workers susceptible - 90% recover without incident
36
What is Hepatitis C?
- Chronic Hepatitis - Cirrhosis - Hepatocellular carcinoma - Contracted through blood transfusion and sexual contact - 50% will develop cancer
37
What is Hepatitis E?
- Caused by the ingestion of food or water contaminated with fecal material
38
What type of Hepatitis is the biggest threat to health care professionals?
Hep B
39
What type of Hepatitis is the principal cause of liver transplants?
Hep C
40
What is Cirrhosis of the liver?
Chronic destruction of liver cells & structure with nodular regeneration of liver parenchyma and fibrosis
41
What is the major cause of Cirrhosis of the liver?
Chronic alcoholism
42
What does ground glass look like?
- Abdominal Haziness | - Caused by large amounts of ascitic fluid
43
What do dog ears look like?
- Pt in supine position | - Peritoneal fluid tends to gravitate showing fluid on both sides of the bladder
44
What are the complications of Cirrhosis?
- Impaired liver function - Splenomegaly - Esophageal varices - Jaundice & Gynecomastia - Edema - Ascites - Portal Hypertension
45
What is the primary liver cell carcinoma?
Hepatocellular Carcinoma
46
Large central mass with small nodules.
Hepatocellular Carcinoma
47
Consistant with Cirrhosis and Chronic Hepatitis B or C.
Hepatocellular Carcinoma
48
Jaundice due to invasion of the biliary tree.
Hepatocellular Carcinoma
49
Pt's with cancer in the colon, Pancreas, stomach, lungs and breasts commonly have tumors in the liver called...
Hepatic Metastases
50
T/ F | Pt's who have Hepatic Metastasis typically have a poor prognosis.
True
51
What are the typical forms of diagnosis of Hepatic Metastasis?
CT/ MRI/ US/ NM CT & MRI are the most sensitive
52
What is Jaundice?
Yellowish discoloration of the skin and white of the eye
53
T/ F | Jaundice is a disease.
False | It is a sign of disease
54
What are the (2) types of Jaundice?
1. Medical or Non obstructive Jaundice | 2. Surgical or Obstructive Jaundice
55
What results in excessive bilirubin in the blood?
Jaundice
56
What is Medical or Non Obstructive Jaundice?
Too many red blood cells are destroyed or liver is damaged. (Cirrhosis, Hepatitis)
57
What is Surgical or Obstructive Jaundice?
Biliary system is obstructed and bile does not enter duodenum
58
What is Hepatic Hemangioma?
Benign neoplasm of poorly formed blood vessels
59
What is a Hepatic Hemangioma?
Well defined solitary tumor
60
What sizes can a Hepatic Hemangioma be?
Microscopic to large
61
T/ F | Hepatic Hemangiomas are more common in women.
True
62
T/ F | There are typically no complications in Hepatic Hemangiomas.
True
63
What is Acute Pancreatitis?
Inflammation of Pancreatic tissue
64
What is the most common cause of Acute Pancreatitis?
Alcoholism
65
Other than alcoholism what is another cause of Acute Pancreatitis?
Obstruction by gallstones or tumor
66
What are complications of Acute Pancreatitis?
- Hemorrhagic pancreatitis - Pseudocysts - Malabsorption syndrome - Abscess - Jaundice
67
When looking at an image of a patient with Pancreatitis you can see ______ of the transverse colon.
Distention
68
When looking at an image of a patient with Pancreatitis you can see ______ of the duodenal sweep.
Distention
69
What is Chronic Pancreatitis?
- Frequent Intermittent injury to the pancreas | - Increasing damage that produces scar tissue
70
Chronic Pancreatitis generally results from...
Chronic alcohol abuse
71
Why does chronic alcohol abuse cause Chronic Pancreatitis?
The Pancreas loses the ability to produce enzymes
72
What are (3) symptoms that identify Chronic Pancreatitis?
1. Pain 2. Malabsorption 3. Diabetes
73
Images of Chronic Pancreatitis show...
Calcification from Pancreatic head to body and tail
74
Barium Studies of Chronic Pancreatitis shows...
- Pancreatic head enlargement causing changes with duodenal sweep - Narrowing of lumen
75
What is a Pancreatic Pseudocyst?
- Loculated (walled off) fluid collections | - Arising from inflammation, Necrosis and hemorrhage associated with Pancreatitis or trauma
76
What does the Pancreatic Pseudocyst look like?
- Shaggy lining surrounded by dense white scar tissue - Pancreatic head shows widening at the sweep - Pancreatic body or tail displaces stomach, proximal jejunum or colon
77
What is another name for Pancreatic Carcinoma?
Adenocarcinoma
78
What is Pancreatic Carcinoma?
Cancer of the granular tissue
79
T/ F | People with Pancreatic Carcinoma typically have a poor diagnosis.
True
80
T/F | Pancreatic Carcinoma is rare before 40.
True
81
What is Pneumoperitoneum?
Free air in the peritoneal cavity - abdominal pain - tenderness
82
What causes a Pneumoperitoneum?
Perforation of gas containing viscus
83
T/ F | Pneumoperitoneum is a surgical emergency.
True
84
Because the gas rises to the highest point in the peritoneal cavity,In a Pneumoperitoneum it accumulates beneath the...
Domes of the diaphragm
85
If a patient cannot stand what is the best view to see a Pneumoperitoneum?
Left lateral decubitus
86
Falciform Ligament is a sign of….
Pneumoperitoneum | - gas on both sides
87
What is Splenomegaly?
Enlargement of the spleen
88
Splenomegaly is associated with...
- Portal hypotension - Hemolytic anemia - Lymphoma - Leukemia - Infections
89
What do images showing Splenomegaly show?
- Inferior border of the spleen below costal margin - Elevation of Hemi diaphragm - Displaced stomach - Downward displacement of left kidney & splenic flexure
90
What causes a splenic rupture?
Trauma or complication of an enlarged spleen - Infection - Leukemia
91
T/ F | Immediate surgery is required for a splenic rupture.
True | Due to rapid loss of blood into abdominal cavity

Pathology (9 decks)

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