part 5

Question 1

What is choleithiasis?

Answer 1

• most common disorder of biliary system
• stones in gallbladder
• stones can migrate to cystic or common bile duct (pain and/or obstruction)

Question 2

What is cholecystitis?

Answer 2

• inflammation of gallbladder
• usually associated with choleithiasis
• caused from stones or sludge

Question 3

What are the risk factors for gallbladder disease?

Answer 3

female
having kids
older than 40
estrogen therapy
sedentary lifestyle
genetics 
obesity

Question 4

this develops when balance that keeps cholesterol, bile salts, and calcium in solution is altered leading to precipitation.

• cause is unknown
• satsis of bile and changes in composition causing biliary sludge

Answer 4

cholelithiasis

Question 5

What can decrease bile flow?

Answer 5

immobility
pregnancy
inflammatory/obstructive lesions of biliary system

Question 6

What are the causes of acalculous cholecystitis (inflammation without gallstones)?

Answer 6

• older adults and critically ill
• prolonged immobility, fasting, prolonged parenteral nutrition, diabetes
• bacteria/chemical irritants
• adhesions, neoplasma, anesthesia, opioids

Question 7

• confined to mucous lining or entire wall
• distended with bile or pus
• cystic duct can become occluded
• scarring and fibrosis after attack

Answer 7

cholecystitis

Question 8

When will gallbladder disease commonly happen?

Answer 8

3-6 hours after a high-fat meal or when pt lies down

• pt may also be tacky, diaphoretic, prostration (weakness)
• referred pain in shoulder/scapula

Question 9

What are the clinical manifestations of gallbladder disease when total obstruction occurs?

Answer 9

-dark amber urine
-clay colored stools
pruritus
intolerance to fatty foods
bleeding tendencies
steatorrhea (fat in stool)

Question 10

-pain
-indigestion
fever/chills
jaundice
pain/tenderness RUQ (referred to right shoulder/scapula)
N/V
restless
diaphoresis
leukocytosis (inflammation)
RUQ or epigastric tenderness
abd rigidity

Answer 10

clinical manifestation of gallbladder disease

Question 11

• fat intolerance
• dyspepsia (upper abd pain)
• heartburn
• flatulence

Answer 11

chronic cholecystitis

Question 12

How do we visualize the gallbladder ?

Answer 12

• ultrasound
• ERCP (endoscopic retrograde cholangiopancreatography) goes to bile duct
• percutaneous transhepatic cholangiography