Pathophysiology of gallbladder/bile duct

Question 1

Gallbladder function

Answer 1

store/concentrate bile during fasting

contract to deliver bile to duodenum when fed

Question 2

Bile ducts function

Answer 2

condiut, route of bile flow for digestion, route of excretion for cholesterol, minerals, certain drugs

Question 3

risk factors for gallstones

Answer 3

5 Fs = fat, female, forty, fertile (pregnant/estrogen), family hx

• also Latin American/Native American
• rapid weight loss
• biliary obstruction

Question 4

types of gallstones

Answer 4

cholesterol (most common), pigment stones (bile stasis), brown (bacterial infection)

Question 5

3 contributing factors to gallstone pathogenesis

Answer 5

lithogenic bile, nucleation (mucin plug), stasis

Question 6

How common is gallbladder cancer?

Answer 6

RARE! 0.5% of cancers

Question 7

prognosis of gallbladder cancer

Answer 7

poor survival–1% alive at 5 years

Question 8

risk factors for gallbladder cancer

Answer 8

gallstones (70% have stones), chronic infection

Question 9

most common gallbladder cancer

Answer 9

adenocarcinoma

Question 10

what is cholodocholithiasis?

Answer 10

stones in bile ducts

Question 11

what is a choledochal cyst?

Answer 11

congenital dilation of common bile duct

• present young usually with findings of biliary obstruction (jaundice, etc)

Question 12

Bile duct carcinoma prevalence and risk factors

Answer 12

Super Rare! most adenocarcinomas

Risk factors: choledochal cyst in older adults, primary sclerosing cholangitis, infections (liver flukes), ? cholelithiasis

Question 13

causes of acute pancreatitis

Answer 13

gallstones (45%), alcohol (35%), other (20%)

Question 14

Causes of chronic pancreatitis

Answer 14

alcohol most common identifiable cause, long-standing duct obstruction, hereditary pancreatitis, large proportion idiopathic (40%)