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DIG: Biweekly 1 > Sos- Biliary System > Flashcards

Sos- Biliary System Flashcards

1
Q

produce and secrete bile

A

hepatocytes

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2
Q

___% of bile is stored in the gallbladder

A

50

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3
Q

R and L hepatic duct join together to form ____

A

common hepatic duct

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4
Q

cystic duct and common hepatic duct join together to form ______

A

common bile duct

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5
Q

common bile duct and pancreatic duct empty through this sphincter into ampulla of vater of duodenum

A

sphincter of oddi

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6
Q

artery that supplies galbladder

A

cystic artery

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7
Q

what layer of mucosa is not seen in the gallbladder

A

muscularis mucosa

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8
Q
A

gallbladder histology

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9
Q

gallbladder comes from what during embryologic development

A

foregut

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10
Q

digestive hormone released by I cells of duodenum

A

Cholecystokinin (CCK)

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11
Q

when chyme enters duodenum; and stimulation by HCl, AA’s, or fatty acids entering duodenum

A

release of CCK

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12
Q

stimulates the gallbladder to contract

A

CCK

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13
Q

stimulates secretion of pancreatic juice

A

CCK

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14
Q

____ and ____ act as negative feedback loop blocking acid production

A

CCK and secretin

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15
Q

secretin’s effect on the pancreas

A

HCO3- production to neutralize acidic chyme

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16
Q

malformation of extrahepatic biliary ducts

A

biliary atresia

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17
Q

this is associated with situs inversus or polysplenia/asplenia

A

biliary atresia

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18
Q

cirrhosis and death within 3 years if no liver transplant performed

A

biliary atresia

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19
Q

jaundice
enlarged abdomen
pale stool
slow weight gain

A

biliary atresia

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20
Q
A

portal triad on bottom left
central vein top right

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21
Q
A

portal fibrosis and bile duct hyperplasia

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22
Q

what caused this

A

biliary atresia

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23
Q

trichrome stain of what

A

portal fibrosis

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24
Q
A

fibrosis of ducts

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25
Q

what is enlarged and why

A

gallbladder; due to an obstruction and bile backup

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26
Q

6 week old presents w/ jaundice and large abdomen

A

biliary atresia

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27
Q

best Rx to cure biliary atresia if available

A

liver transplant

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28
Q

triangle of Calot borders

A

top: lower liver margin
lateral: cystic duct
medial: common hepatic duct

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29
Q

what to clamp when removing gallbladder

A

cystic a. and cystic duct

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30
Q

what does the liver mainly live off of

A

nutrients from portal vein (20% O2 from hepatic a.)

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31
Q

what to do if pt. has RUQ pain

A

exam, U.S. labs

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32
Q

elevated Alk Phos can mean what

A

bone issues or biliary tract damage

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33
Q

labs for biliary tract damage

A

elevated bilirubin
elevated GGT and ALP

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34
Q

decreased liver fxn lab

A

decreased albumin

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35
Q

elevated ____ levels during clinical f/u are often liver or bone induced elevations

A

ALP

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36
Q

biliary disease sx’s

A

jaundice
RUQ pain that radiates to back
N/V
fatigue
fever
itching

37
Q

pt has RUQ pain that radiates to back
postprandial pain

A

cholelithiasis (stone)/biliary colic (sludge)

38
Q

inflammation to gallbladder due to stones or sludge

A

acute cholecystitis

39
Q

RUQ pain that radiates to back
fever, N/V
+ murphy’s sign

A

acute cholecystitis

40
Q

inflammation of duct system

A

cholangitis

41
Q

abd pain + fever + jaundice (charcot triad)

A

ascending cholangitis

42
Q

abd pain + fever + jaundice (charcot triad) + confustion and hypotension

A

reynolds pentad (for cholangitis)

43
Q

gallstone that gets trapped in pancreatic duct

A

gallstone pancreatitis

44
Q

what makes up biliary sludge

A

bile, cholesterol, and Ca2+

45
Q

starts from biliary sludge; sudden RUQ pain that radiates to back; N/V

A

cholelithiasis (gallstones)

46
Q

85% of gallstones are made of what; diet induced

A

cholesterol

47
Q

radiolucent stone but can be seen with U.S

A

cholesterol gallstone

48
Q

blood involved in the stone

A

black stone (gallstone)

49
Q

seen in alcoholic liver disease and chronic hemolysis (anemia)

A

black stones

50
Q

these stones are radiopaque but still seen on US

A

black stones

51
Q

greasy stones seen in parasitic infection

A

brown stones

52
Q

the 2 arrows in the circle

A

top: sludge
bottom: gallstone

53
Q

compression of common hepatic duct caused by obstruction of cystic duct (no bile coming out of system and liver backup)

A

Mirizzi Syndrome

54
Q

sudden RUQ pain due to obstruction from sludge or stone

A

biliary colic

55
Q

biliary colic due to obstructed duct

A

acute cholecystitis

56
Q

neutrophils seen in this cholecystitis

A

acute

57
Q

result of recurrent acute cholecystitis

A

chronic cholecystitis

58
Q

chronic inflammation w/ fibrosis and trapped mucosal glands

A

chronic cholecystitis

59
Q

Rokitansky-Aschoff sinuses

A

trapped mucosal glands seen in chronic cholecystitis

60
Q

lymphocytes and macrophages seen in this cholecystitis

A

chronic cholecystitis

61
Q
A

chronic cholecystitis

62
Q

inflammation of biliary duct system mainly due to obstruction

A

cholangitis

63
Q

obstructed areas

A

cholangitis

64
Q

choledocholithiasis

A

gallstones in common bile duct

65
Q

complication of chronic cholecystitis when a stone passes through a fistula b/t the gallbladder and small bowel and travels to ileum

A

gallstone ileus

66
Q
A

seen in gallstone ileus

67
Q

dystrophic calcification of gallbladder wall; may lead to gallbladder cancer if left in

A

porcelain gallbladder

68
Q
A

porcelain gallbladder

69
Q
A

porcelain gallbladder

70
Q

autoimmine attacking of the INTRAhepatic ducts (women in their 50’s)

A

primary biliary cholangitis

71
Q

this leads to cirrhosis

A

primary biliary cholangitis

72
Q

inflammation that will eventually lead to scarring

A

primary biliary cholangitis (cirrhosis)

73
Q

scarring leading to trapped bile in liver and cyst formation

A

primary biliary cholangitis

74
Q

chronic inflammatory destruction of INTRA and EXTRAhepatic bile ducts

A

primary sclerosing cholangitis

75
Q

fibrosis and blocked ducts trap bile (bead on string) and leads to cirrhosis

A

primary sclerosing cholangitis

76
Q
A

primary sclerosing cholangitis

77
Q
A

primary sclerosing cholangitis

78
Q
A

cirrhosis

79
Q
A

cirrhosis

80
Q

80% of patients who have primary sclerosing cholangitis will have what

A

ulcerative cholitis

81
Q

what has an increased risk of cholangiocarcinoma

A

primary sclerosing cholangitis

82
Q

men more than women
bile ducts affected from intra + extrahepatic
80% will have ulcerative cholitis

A

primary sclerosing cholangitis

83
Q

women more than men
intrahepatic bile ducts affected
medical treatment offered

A

primary biliary cholangitis

84
Q

cancer of biliary duct system

A

cholangiocarcinoma

85
Q
A

biliary disease and cholangiocarcinoma

86
Q

risk factors include:
primary sclerosing cholangitis
smoking
age>50
chronic liver disease

A

cholangiocarcinoma

87
Q

uncommon
female predominance
60-70 yrs of age

A

gallbladder adenocarcinoma

88
Q
A

gallbladder adenocarcinoma

DIG: Biweekly 1 (11 decks)

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