OnlineMedEd: Gastroenterology - "Gallbladder" Flashcards
The ____________ connects the gallbladder to the bile duct.
cystic duct
What are the five F’s of gallstones?
- Fat
- Female
- Forty
- Fertile (estrogen-induced)
- Family
In medical abbreviation, c with a line over it means _________.
“with”
If the person with gallstones is not a surgical candidate, then you can prescribe _____________.
ursodeoxycholic acid
You can have ____________ without having cholecystitis.
cholelithiasis
Ultrasound of the gallbladders of those with cholecystitis will show what three things?
- Cholelithiasis
- Thickened gallbladder wall
- Pericholecystic fluid
Note: US does not usually show the obstruction!
How will the history differ between cholelithiasis and cholecystitis?
Cholelithiasis presents with colicky, intermittent pain, while cholecystitis presents with constant pain.
Describe how the HIDA scan works.
- In the HIDA scan, the intravenous dye will be pumped from the liver to the bile duct.
- If the cystic duct is not obstructed, then the dye will fill into the gallbladder.
- If the cystic duct is blocked, then the cystic duct will not take up dye.
How should cholecystitis be treated?
- IVF
- IV abx
- NPO to prep for surgery
Choledocholithiasis can present with two additional syndromes: ______________.
hepatitis (from bile duct obstruction) and pancreatitis
True or false: those with cholelithiasis will have a positive Murphy’s sign.
False
Murphy’s sign is positive in those with inflammed gallbladder, so it will be positive in choleCYSTITIS.
How is choledocholithiasis diagnosed?
US can show dilated bile duct, but MRCP is needed to view the obstruction.
If the liver enzymes go up and down cyclically in a patient with symptoms concerning for choledocholithiasis, then ____________.
there is probably a ball-valve effect happening with the gallstone (it is going up and down, periodically blocking the flow)
Cholangitis is usually caused by what types of bacteria?
- GNR
* Anaerobes
What is the triad that suggest cholangitis (both the symptoms and the name!)?
Charcot’s triad:
•Fever
•RUQ pain
• Jaundice
Bonus points: Reynold’s pentad is this with hypotension and AMS.
How is the diagnosis and treatment of cholangitis different from choledocholithiasis?
Both start with an US to rule out cholecystitis. If the US is negative and the person has Charcot’s triad or Reynold’s pentad, then you skip MRCP and HIDA and move straight to ERCP to remove the blockage. IVF and abx are still given.
People often give Zosyn (pip/taxo) for cholangitis, but the best is actually _______________.
ciprofloxacin and metronidazole or amp/gent and metronidazole
