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Y3R6: Surgery I 👨‍⚕️ > L11: Gall Stones > Flashcards

L11: Gall Stones Flashcards

1
Q

Functions of Gall Bladder

A
  • Reservoir or Bile
  • Concentration of Bile
  • Mucus Secretion
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2
Q

Resrvoir For Bile

A
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3
Q

Bile is excreted by …..

A

The liver

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4
Q

Bile is stored in …..

A

The gall bladder

Total of about 500 to 1000 ml per day

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5
Q

Release of Bile

A
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6
Q

Concentration of Bile

A
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7
Q

How much bile is water?

A

98%

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8
Q

How Much is bile concentrated?

A

Get concentrated 5-10 times

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9
Q

How is Bile Concentrated?

A
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10
Q

Results of Bile Concentration

A
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11
Q

Mucus Secretion by Gall Bladder

A
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12
Q

Amount of mucus by GB

A

Secretes about 20 ml of mucus per day

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13
Q

Surgical Importance of mucus secreted by GB

A

Obstruction to the cystic duct causes mucocele of the

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14
Q

Bile is formed of …..

A
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15
Q

pH of Bile

A

More Than 7

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16
Q

Amount Of Bile

A

500-1000 ml/day, 98% is water.

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17
Q

Capacity of GB

A

Gall bladder is 40-50 ml

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18
Q

Release of Bile

A

Fatty food stimulation releases cholecystokinin results in:

  1. Stimulates gall bladder to contract.
  2. At the same time, the sphincter of Oddi to relax.
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19
Q

Content of Bile

A
  • Inorganic ions (more than plasma)
  • Hence, severe electrolyte imbalance is seen in the biliary fistula
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20
Q

Fate of Bile

A

They are metabolized in the colon to deoxycholic acid & lithocholic acids.

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21
Q

Function of Bile

A
  • Main function of bile acids in the bile is To maintain cholesterol in the solution
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22
Q

Another Name of Gall Stone Disease

A

Cholelithiasis

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23
Q

Etiology of Gall Stone Disease

A
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24
Q

Metabolic Causes of Gall Stone Disease

A

Conditions that increase cholesterol secretion & can results in stone formation:

  1. Obesity
  2. High-calorie diet
  3. Medications
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25
Q

Cholesterol

  • Production
  • Gives Rise to
  • Execretion
A
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26
Q

Cholesterol is water insoluble so…

A
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27
Q

What maintains cholesterol in liquid form?

A
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28
Q

Mechanism of stone formations

A
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29
Q

Infections & Gallstones

A

The most common cause responsible for a gall stone in 80% of patients

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30
Q

Source of infections causing GSD

A

tonsils, tooth, bowel, etc.

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31
Q

Causative Organisms of GSD

A

Caused by organisms such as:

  1. E. coli
  2. Proteus
  3. Anaerobic organisms
  4. Streptococci
32
Q

Route of Infection in GSD

A

Reach the gall bladder wall through the blood stream.

33
Q

Effect of infections in GSD

34
Q

Causes of Bile stasis

35
Q

Types of stones in Bile stasis

A

They are prone to mixed stones as a result of bile stasis.

36
Q

Causes of Decreased bile acid pool

37
Q

Examples of Hemolytic Anemias Causing GSD

A

1) Hereditary spherocytosis
2) Sickle cell anemia

38
Q

Mechanism of Hemolytic Anemias Causing GSD

39
Q

Saint’s Triad

40
Q

Parasitic Infestations Causing GSD

41
Q

Causes of GSD due to abnormal mucus

A

Congenital cystic fibrosis

42
Q

Mechanism of GSD due to abnormal mucus

A

Gallstones occur in these children due to impairment of bile flow.

43
Q

Other Diseases associated with GSD

A

1) Diabetes mellitus.
2) Type IV hyperlipoproteinemia.
3) Cirrhosis of liver.
4) Fistulae on treatment with total parenteral nutrition.
5) Gastric surgery.

44
Q

Different Types of GB Stones

A
  • Mixed
  • Cholesterol
  • Pigment
  • Brown Pigment
45
Q

Incidence of Mixed Stones

A

They constitute about 80% of gall stones

46
Q

Structure of Mixed Stones

47
Q

Characters of Mixed Stones

48
Q

Incidence of Cholesterol Stones

A

They constitute about 10% of gall stones

49
Q

Cause of Cholesterol Stones

A
  • Occur in patients with increased cholesterol levels.
  • Occurs in aseptic bile
50
Q

RF for Cholesterol Stones

A
  • Fatty women are commonly affected
51
Q

Structure of Cholesterol Stones

A
  • Precipitation of cholesterol gives rise to stones.
  • Pigment can also get precipitated along with cholesterol.
52
Q

Characters of Cholesterol Stones

53
Q

Symptoms of Cholesterol Stones

A

Such stones can be silent for many years.

54
Q

Radiology of Cholesterol Stones

A

They are radio lucent

55
Q

Incidence of Pigment Stones

A

They constitute about 5-10% of gall stones

56
Q

Causes of Pigment Stones

57
Q

Structure of Pigment Stones

A

Calcium bilirubinate stones.

58
Q

Characters of Pigment Stones

59
Q

Incidence of Brown Pigment Stones

A

Rare in gall bladder, occurs in bile duct

60
Q

Cause of Brown Pigment Stones

61
Q

Structure of Brown Pigment Stones

A
  • Calcium bilirubinate - calcium palmitate - calcium stearate.
  • Cholesterol.
62
Q

Clinical features & complications of gall stones

63
Q

Causes of Silent Gallstones

A

Usually in single, silent, cholesterol stone that is symptomless.

64
Q

Dx of Silent Gallstones

65
Q

TTT of Silent Gallstones

A

It can be left alone without treatment (This stone rarely causes obstructive jaundice)

66
Q

Flatulent Dyspepsia in GSD

67
Q

Cause of Gall Stone Colic

A

due to spasm of gall bladder

68
Q

Site of Gall Stone Colic

A

Upper abdominal pain felt in the right hypochondrium

69
Q

Nature of Gall Stone Colic

A

Severe colicky pain

70
Q

Radiation of Gall Stone Colic

A
  • May shoot to the back or between shoulder blades
  • Pain may radiate to chest also.
71
Q

PPT Factors for Gall Stone Colic

A
  • At night in the supine position (The stone tends to block the cystic duct or neck of gallbladder)
72
Q

Course of Gall Stone Colic

A

Continuous

73
Q

Duration of Gall Stone Colic

A

Lasts for a few min to few hours

74
Q

Associated Symptoms of Gall Stone Colic

A

1) Vomiting due to reflex pylorospasm.
2) Restlessness.
3) Sweating.

75
Q

Tenderness in Gall Stone Colic

A

There is tenderness in the right hypochondrium.

Y3R6: Surgery I 👨‍⚕️ (36 decks)

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