Quiz 5

Question 1

Gall bladder stones (cholelithiasis) is associated with the 4 F’s (female, forty, ___and fertile) and has an increased incidence in _______ _______. risk factors include ________ bile acids and _________ cholesterol in the bile

Answer 1

fat

native americans

decreased

increased

Question 2

types of gall stones:
-______ stones are the most common (80% of cases)

• pigment stones (10%)- jet black, small stones that are strongly suggestive of extravascular _______ anemia (sickle cell disease).

Answer 2

mixed

hemolytic

Question 3

_________(inflamation of the gall bladder) could be acute or chronic and it is most common in ______. most commonly due to an _______ stone (90% of the time) in the cystic duct. chemical irritation of the mucosa due to increased bile concentration leads to bacterial invasion. the most common is _____

Answer 3

Cholecystitis

women

impacted

E.coli.

Question 4

Acute Cholecystitis:
-____ gall bladder, edema of the wall and possible necrosis and fibrinosuppurative _____; also ulceration and stones normally present.

-pain occurs ___-___ minutes after eating, the pain radiates to the right shoulder

Answer 4

Large

exudate

15-30

Question 5

______ Cholecystitis:
- _______ gall bladder with fibrosis, the wall is thick and gray-white in color, stones ARE present

• severe, persistent pain ___ hours postprandially in the evening with calcification of gallbladder seen on x-ray

Answer 5

Chronic

Contracted

1-2

Question 6

_____ tumors of the gall bladder are very rare and resemble ______ or papilloma

Answer 6

benign

polyps

Question 7

the most common cancerous tumor of the biliary tree is ___________ and is predominantly found in ______ over the age of 50; well established relationship with cholelithiasis and related to obstruction and ______ infiltration.

Answer 7

adenocarcinoma

women

liver

Question 8

Cystic Fibrosis (congenital) is a disorder of the ______ gland seen in infancy or childhood, it has the highest incidence in caucasians, located on chromosome __. there is atrophy of _____ and _____ tissues.

• it is characterized by pancreatic insufficiency and recurrent pulmonary infections
• presents with steatorrhea, malabsorption (leading to vitamin A,D,E,K defficiencies) and excess ____ in the sweat caused by defect in ___________
• death commonly involved with pulmonary infections (_________ _________)

Answer 8

exocrine

7

ductal

acinar

salt

Chloride

pseudomonas aeruginosa

Question 9

Acute Pancreatitis is necrosis of the pancreas caused by activated pancreatic enzymes; 70% association with alcoholism and gallstone diseases; causes ______ cell injury.

• the most common pathology is ________ but the most severe is ________
• enzymatic necrosis = ________ necrosis
• midepigastric pain, grey ______ sign (purple color around flank) and cullen’s sign (purple color around ________)
• death in adults = _______
• complications = DIC, abscess, renal failure, shock, secondary infection…

Answer 9

Acinar

edematous

hemorrhagic

coagulative

turner’s

Umbillicus

ARDS

Question 10

chronic pancreatitis AKA chronic relapsing pancreatitis is MC associated with ______ ______ in adults and ______ _____ in children; the ducts are dialated with “_____ __ _____” appearance; the most common complaint is persistant epigastric pain

Answer 10

alcohol abuse

cystic fibrosis

chain of lakes

Question 11

Pancreatic Adenocarcinoma is a well differentiated cancer that begins in the
ductal epithelium and spreads to the exocrine gland. most commonly in the _____ of the pancreas and affects ____ over 50 years old.

• the gold marker for pancreatic carcinoma is ______ in blood tests.
• the prognosis is extremely poor
• there can be weight loss, distension in gall bladder, epigastric or periumbilical pain or ______ jaundice.

Answer 11

head

men

CA 19-9

obstructive