Lesson 2A (Part 2) Flashcards
AST
Aspartate aminotransferase
- an enzyme
When is AST released?
When cells are injured or damaged
What is AST used for?
To diagnose liver disease before jaundice occurs
What is elevated levels of AST associated with? (3)
- Cirrhosis
- Hepatitis
- Mononucleosis
What are 2 types of congenital anomalies/variants of the GB?
- Duplication
- rare - Multiseptated
What is cholelithiasis?
A gallstone disease
What are the risk factors of cholelithiasis? (6)
- Increasing age
- Female
- Fecundity(premenopausal women increased estrogen
- increase risk cholesterol levels and decrease GB contractions - Obesity
- Diabetes
- Pregnancy
What are 2 complications of cholelithiasis?
- Biliary colic
2. Acute cholecystitis
What is the sonographic appearance of cholelithiasis?
Echogenic appearance with strong posterior acoustic shadowing
- small echogenic stones <5mm may not shadow
What is a key feature of stones allowing differentiation from polyps?
If they are mobile or not
- mobile = stones
- not mobile = polyps
WES
Wall echo shadow
How does WES complex work? (3)
- Gallbladder wall is first visualized in the near field
- Bright echo of the stone
- Acoustic shadowing
What is milk of calcium bile?
Its is a rare condition where the GB is filled with semisolid calcium carbonate
What is milk of calcium bile caused by?
Stasis
What does milk of calcium bile rarely cause?
Acute cholecystitis
What does milk of calcium bile look like on US?
Forms a bile calcium level
How does biliary sludge appear?
- As amorphous low-level echoes with no acoustic shadowing
2. Normal GB wall
What happens to the sludge when you change a persons body position?
It can move
What does biliary sludge lack?
Vascularity
What can tumefactive sludge (sludge balls) mimic?
Polyps
What is biliary sludge also known as? (2)
- Biliary sand
2. Microlithiasis
What are predisposing factors of biliary sludge? (4)
- Pregnancy
- Rapid weight loss
- Prolonged fasting
- Critical illness
What are potential complications of biliary sludge? (3)
- Biliary colic
- Acalculous cholecystitis
- Pancreatitis
What are the signs and symptoms of acute cholecystitis? (4)
- RUQ pain that is constant
- Epigastric pain
- RUQ tenderness
- Nausea/vomiting
What is acute cholecystitis caused by?
Stones
- 90% of the time
Who is affected more by acute cholecystitis?
Women
- 3x more likely
- <50 year old group
What can the impact of stones in the cystic duct or GB neck cause? (8)
- Obstruction of bile flow
- intrahepatic duct dilatation - Luminal distension
- Ischemia
- Superinfection
- Necrosis
- Fever
- Leukocytosis
- Increased ALP & bilirubin
What is the sonographic appearance of acute cholecystitis? (8)
- Gallstones
- Thickening GB wall
- > 3mm - Edematous
- differentiation of layers - Distention of GB lumen
- >4cm transverse - Impacted stone of CD or GB
- Pericholecystic fluid collection
- Hyperemic wall
- vascular (peripheral) - Intrahepatic duct/CBD dilation
