Pathology: Biliary Tree and Pancreas Flashcards
what is cholelithiasis?
gallstones
what is found in normal bile?
micelles of cholesterol
phospholipids
bile salts
bilirubin
is cholesterol hydrophobic or hydrophillic?
hydrophobic
are bile salts hydrophobic or hydrophilic?
hydrophilic
what causes the release of bile into the duodenum?
cholecystokinin
what is the role of the gallbladder?
it stores and concentrates bile
when do cholesterol gallstones form?
when there is an imbalance in the ratio between cholesterol and bile salts, disrupting micelle formation
name four risk factors for cholesterol excess in bile
being female
obesity
diabetes
genetics
what are two types of gallstones?
cholesterol
pigment
what causes pigment gallstones?
an excess of bilirubin which can’t be dissolved by bile salts
what is a mucocele?
a mucous cyst
what is cholecystitis?
inflammation of the gallbladder
what are the two types of cholecystitis?
acute and chronic
what causes acute cholecystitis?
gallstones obstructing the outflow of bile
what are three possible complications of acute cholecystitis?
empyema
rupture
peritonitis
what does acute cholecystitis cause after 2-3 days?
intense adhesions
when can chronic cholecystitis develop?
insidiously or after bouts of acute cholecystitis
what happens to the gallbladder wall in chronic cholecystitis?
it becomes thickened but not distended
what type of cancer occurs in the gallbladder?
adenocarcinoma
what organ can adenocarcinoma of the gallbladder invade?
the liver
what is the prognosis for adenocarcinoma of the gallbladder like?
poor
what is carcinoma of the bile ducts called?
cholangiocarcinoma
name two conditions that are associated with cholangiocarcinoma
ulcerative colitis
primary sclerosing cholangitis
what does cholangiocarcinoma present with?
jaundice
what is pancreatitis?
inflammation of the pancreas
what are the two types of pancreatitis?
acute and chronic
how does acute pancreatitis present?
sudden onset of severe abdominal pain
what blood result indicates acute pancreatitis?
elevated serum amylase
what effect does lipase autodigestion have on the pancreas?
intra and peripancreatic fat necrosis
what effect does protease autodigestion have on the pancreas?
tissue destruction and haemorrhage
name four possible complications of acute pancreatitis
death
shock
pseudocyst formation
abscess formation
name two electrolyte imbalances that acute pancreatitis can cause
hypocalcaemia
hyperglycaemia
what is chronic pancreatitis?
a relapsing disorder that may develop insidiously of after bouts of acute pancreatitis
what happens to the pancreas in chronic pancreatitis?
pancreas tissue is replaced by inflammation and scar tissue, acini and islets are destroyed
name three things associated with carcinoma of the pancreas
smoking
diabetes
familial pancreatitis
what is the prognosis for pancreatic cancer like?
poor
where can a carcinoma of the head of the pancreas invade?
the duodenal wall
what can a carcinoma of the head of the pancreas obstruct?
the common bile duct
what can a carcinoma of the tail pancreas invade?
the spleen
where can carcinoma of the pancreas metastasise to via the haematogenous route?
the liver
name three organs that pancreatic cancer can directly spread to
duodenum
stomach
spleen
