Pancreaticobiliary Diseases (Quiz 3) Flashcards
the gallbladder is _____ during the fasting state
- relaxed
the gallbladder is ______ during the postprandial state
- contracted
what does chole mean
- bile or gall
what does cholecysto mean
- bile sac
what does choledocho mean
- bile duct
what does cholangio mean
- bile duct
what does cholestasis mean
- stasis of bile in gallbladder
what does biliary colic mean
- spasm of biliary tree causing pain
what does cholelithiasis mean
- gallstones
what does choledocholithiasis mean
- gallstones in bile duct
what does cholecystitis mean
- inflammation of gall bladder
what does cholangitis mean
- inflammation of bile ducts
what is the most common type of gallstone
- cholesterol
where are cholesterol gallstones located
- gallbladder
where are black gallstones located
- gallbladder
what is the calcium and bilirubin content of black gallstones
- high
where are brown gallstones located
- bile ducts
what is the pathogenesis of brown gallstones
- infectious
which sex is most predisposed to gallstones
- females
what presents with RUQ pain, fever, normal LFTs, but increased WBC count
- cholecystitis
what presents with acholic stool and dark urine
- choledocholithiasis w/ obstruction
what is Charcot’s triad
what is it associated with
- fever
- RUQ pain
- jaundice
- ascending cholangitis
what is the function of the exocrine pancreas
functional unit
- secretes digestive enzymes and proenzymes into a system of ducts
- acinus
what is an acute inflammatory disorder of the pancreas that is commonly associated with fever, nausea, abdominal pain, and elevated pancreatic enzymes in the blood
- acute pancreatitis
what is the final common pathway of acute pancreatitis
leads to
- premature activation of digestive enzymes
- autodigestive necrosis of pancreatic tissues
how does gallstone pancreatitis occur
- gallstone passes into common bile duct and lodges in ampulla
- trypsinogen activates to trypsin within the pancreas and causes tissue destruction
how do we diagnose interstitial edematous acute pancreatitis
- elevated amylase and/or lipase
- check LFTs
- ultrasound
between amylase and lipase, which is more sensitive?
which is more specific
- amylase is sensitive
- lipase is specific
cholestatic pattern of elevated LFTs shows what
- elevated bilirubin and/or alkaline phosphatase
what is severe pancreatitis with extensive peripancreatic and pancreatic tissue destruction
due to
- necrotizing acute pancreatitis
- systemic inflammatory response
two signs pathognomonic for necrotizing acute pancreatitis
- Cullen sign
- grey-turner sign
complications of necrotizing acute pancreaitis
- pseudocyst
- duct rupture
- fistula
what are collections of fluid surrounded by inflamed fibrous tissue
- pseudocyst
what is a progressive fibroinflammatory disorder of the pancreas associated with a loss of pancreatic parenchyma and function
- chronic pancreatitis
diagnostic tests for chronic pancreatitis
- low fecal elastase levels
- pancreatic calcification
what’s a big difference grossly between acute and chronic pancreatitis
- acute - enlarged pancreas
- chronic - shrunken pancreas
complications of chronic pancreatitis
- pseudocyst
- splenic vein thrombosis
- cancer
strong association for pancreatic adenocarcinoma
- tobacco
why is pancreatic ductal adenocarcinoma so hard to resect
- lot of structures close to the pancreas
- metastasis
what is common in the adjacent tissue of ductal adenoarcinoma
- chronic pancreatitis
jaundice is common with tumors of which part of the pancreas
- head
