Module 9: gall bladder/pancreas/malignancies

Question 1

Cholelithiasis risk factors

Answer 1

obese, rapid weight loss, middle age, female, bc, native american, ileal disease, low HDL, hypertriglyceridemia

Question 2

Gallstones made of

Answer 2

bile, cholesterol, and bilirubin

Question 3

Estrogen causes gallstones how
rapid weight loss-
malabsorption-

Answer 3

estrogen= vBile acid synthesis, ^Liver cholesterol secretion
gallbladder sludge
vBile salt absorption which maintain solubility of cholesterol

Question 4

Gallstones <8mm cause biliary colic how

if large enough will cause

Answer 4

stones obstruct common bile duct =spasms/contraction of duct (RUQ/epigastric)

obstructive jaundice

Question 5

biliary colic pain lasts __-__hours or until _____

Answer 5

2-8hrs or until there’s no more food stimulating gallbladder contraction

Question 6

people w cholelithiasis are intolerant to _____foods bc they stimulate _____ to release bile

Answer 6

fatty foods stimulate gallbladder contraction to release bile

Question 7

gallstone pain typically experienced in ___,___,____ or epigastric
experience __/___

Answer 7

back, r shoulder, right scapula

n/v

Question 8

Cholecystitis results from ___ in the biliary tract
acute is associated w ____ bc it causes ____,___,____
all which = ___,___,____ (good for staph/strep growth)

Answer 8

obstruction in the biliary tract
cholelithiasis= irritation, mucosal swelling, ischemia
=====venous congestion, lymphatic stasis, inflammation

Question 9

Chronic cholecystitis caused by ____

vague, only marked by

Answer 9

repeated episodes of acute or chronic irritation by stones

GERD

Question 10

acute cholecystitis will have same sx as stones also will have positive ____ or _____

lab abnormalities:____, ^___, ^___

Answer 10

positive murphys sign or rebound tenderness

leukocytosis, ^alkphos, ^bilirubin

Question 11

Pancreatitis risk factors

Answer 11

obstructive biliary tract, etoh, smoking, drugs, PUD, abdominal trauma, hld, genes

Question 12

Pancreatitis caused by

igetsmahv

Answer 12

ischemia, gallstones, ercp, trauma, scorpion, meds, autoimmune, high triglycerides, viral infections

Question 13

Esophageal cancer
Squamous cell carcinoma
Adenocarcinoma
sx are late and include ___ and___

Answer 13

upper portion d/t drinking/smoking
lower portion d/t smoking, obesity, reflux, sliding hiatal hernia
cp and dysphagia

Question 14

Colorectal CA risk factors

Answer 14

50+, ^fat/vFiber, smoking, obese, fam hx, sedentary, IBD, gastrectomy

Question 15

Most colorectal tumors are ___ and grow ___

Answer 15

adenocarcinomas w slow growth

Question 16

CRC most commonly arises from ____

malignant potential if >__cm and assc w ____

Answer 16

polyps

2cm , associated w many (20+) with villous architecture

Question 17

Colorectal sx

Answer 17

pain, abd mass, anemia, occult bleeding, obstruction, distention

Question 18

Pancreatic CA increases w

risk factors:

Answer 18

age, males, AA

ETOH, fam hx, smoking, nonOblood type, DM2, chronic pancreatitis

Question 19

Pancreatic tumors can arise from ___ or ____ cells, most from and metastasize to ___

Answer 19

exocrine or endocrine, mostly exocrine (ductal adenocarcinomas)
mets to liver

Question 20

Pancreatic head tumors grow ____ and can obstruct the _____ and ____

Answer 20

quickly

obstruct portal vein and common bile duct

Question 21

The ____mutation (photo-oncogene) associated w pancreatic CA

Answer 21

K-ras

Question 22

Pancreatic CA s/s

Answer 22

jaundice, back pain, protein/fat malabsorption d/t vEnzymes w obstruction
lethargy, weight loss, n/v, DM, change in bowel paterns, itching