Pancreatitis and GB

Question 1

What are the two types of Cholelithiasis?

What are their features?

Answer 1

Mixed stones:
* Pure cholesterol or
* Cholesterol/ bilirubin/
Ca+ carbonate

Pigment Stones:
* Jet black
* suggest extravascular 
  hemolytic anemia (ex:   
  sickle cell)

Question 2

Indicidence of Cholelithiasis

Answer 2

• 40- 60 y/o
• (f)
• Native American

Question 3

Predisposing factors of Cholelithiasis

Answer 3

Predisposing factors:
• DM
• Cirrhosis
• Chronic extravascular hemolysis

Question 4

What are the 4 F’s of cholelithiasis

Answer 4

• female
• forty
• fat
• fertile

Question 5

What ducts can be obstructed in a cholelithiasis

Answer 5

cystic duct

common bile duct

Question 6

cholelithiasis can predispose a person to ____

Answer 6

BG CA

Question 7

Complications of ____ can cause:

• Obstruction (cystic duct or common bile duct)
• Acute Cholecystitis
• Biliary fistula to the ileus

Answer 7

Cholelithiasis

Question 8

_______: Inflam of the GB

Answer 8

Cholecystitis

Question 9

Indicdence of Cholecystitis

Answer 9

women

Question 10

What is the MCC of cholecystitis

Answer 10

impacted stone of the cystic duct

Question 11

_______: Chem irritation of the mucosa due to incr bile concentration → leads to bact. Invasion

Answer 11

cholecystitis

Question 12

MC bact. that effects cholecystitis

Answer 12

E. Coli

Question 13

What is the difference btw acute and chronic Cholecystitis

Answer 13

Acute: Necrosis and fibrosuppurative exudate

Chronic: Contracted GB, thick gray white wall

Question 14

acute cholystitis: there is pn in _____ after eating
location of pn: _____

Chronic: pn in _____ after eating

Answer 14

acute: 15-30 min at the R. shoulder

Chronic: 1 to 2 hrs

Question 15

MC CA tumor of the GB

Answer 15

at the biliary tree

- adenocarcinoma

Question 16

Incidence of CA of the GB

Answer 16

woman 50+

Question 17

_____: Systemic disorder of exocrine gland secretion in infants

Answer 17

cystic fibrosis

Question 18

incidence of cystic fibrosis

Answer 18

caucasion

infancy

Question 19

Etiology of Cystic fibrosis

Answer 19

autosomal recessive

on chromosome 7

Question 20

What structures will atrophy during cystic fibrosis

Answer 20

ductal and acinar tissue

Question 21

A clinical finding of cystic fibrosis is ___

Answer 21

recurrent pulm infection

Question 22

Lab test for cystic fibrosis

Answer 22

sweat test

Question 23

___: Necrosis of the pancreas caused by release of activated pancreatic enzymes

Answer 23

Acute pancreatitis

Question 24

Incidence of Acute pancreatitis

Answer 24

alcoholism and GB dx

Question 25

____: obstruction of duct → bile reflux → accumulation of pancreatic enzymes = Acinar cell injury

Answer 25

acute pancreatitis

Question 26

What type of necrosis will be seen in acute pancreatitis

Answer 26

Enzymatic necrosis = coagulation necrosis

Question 27

What type of pn will be experienced in acute pancreatitis

Answer 27

Midepigastric pn: through back to the periumbilical area

Question 28

___ sign & ___ sign seen in acute pancreatitis

Answer 28

grey turner’s sign

cullen’s sign

Question 29

Mortality in acute pancreatitis is due to ____

Answer 29

ARDS

Question 30

Cause of chronic pancreatitis in adults vs children

Answer 30

• MC: ass. w/ alcohol abuse

* MC in children: cystic fibrosis

Question 31

chronic pancreatitis will have ducts dilated in “____”

Answer 31

Chain of lakes

Question 32

MC complaint of chronic pancreatitis

Answer 32

persistent pn in the epigastric region

malabsorption w/ steatorrhea