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Pathopharmacology I > Wk 4 Gallbladder Problems > Flashcards

Wk 4 Gallbladder Problems Flashcards

1
Q

What is cholelithiasis?

A

Gallstones

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2
Q

What is cholyecycstitis?

A

Inflammation of the gallbladder

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3
Q

What is the etiology of cholelithiasis?

A

Unknown

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4
Q

How are gallstones removed?

A

Surgery

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5
Q

What are 7 risk factors for cholelithiasis?

A

Gender
Age, over 40
Estrogen
Obesity
Sedentary lifestyle
Diet
Family history

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6
Q

What causes severe pain of cholelithiasis?

A

Gallstones migrate and get stuck in the bile duct

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7
Q

Gallstones affect what percentages of men and women?

A

6% of men
9% of women

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8
Q

What diet is a risk factor for gallstones?

A

High in cholesterol and fat
Low in fiber

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9
Q

Where does bile come from?

A

Liver

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10
Q

Where is bile stored?

A

Gallbladder

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11
Q

Why does the gallbladder release bile?

A

After we eat to help with fat digestion

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12
Q

What is the function of bile?

A

It helps to digest lipids and transport waste products

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13
Q

What are the 6 components of bile?

A

Bilirubin
Cholesterol
Bile salts
Water
Protein
calcium

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14
Q

What gives bile its color?

A

Bilirubin, it’s dark brownish color

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15
Q

How does the pathogenesis of cholelithiasis start?

A

Bile stasis

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16
Q

What happens when there is bile stasis?

A

It becomes super saturated with cholesterol

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17
Q

What happens when bile is saturated with cholesterol?

A

It forms precipitates which form the gallstones

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18
Q

3 steps to gallstone formation

A

Bile stasis
Cholesterol accumulation
Precipitate formation

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19
Q

What are 3 things that can happen if the gallstones migrate?

A

Pain
Obstruction
Cholecystitis

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20
Q

What quadrant is the pain located?

A

RUQ

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21
Q

What symptom will the patient present with if there is a bile duct obstruction?

A

obstructive jaundice with increased conjugated bilirubin

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22
Q

What is conjugated bilirubin?

A

Water-soluble bilirubin

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23
Q

If the stones are small, few and not moving the cholelithiasis manifestations will be

A

Silent

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24
Q

Severity of manifestations depends on…

A

Movement of stones
Obstruction

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25
Q

The pain associated with gallstones in the bile duct is known as what?

A

Biliary colic

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26
Q

Biliary colic is a __ __ pain

A

Steady severe pain

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27
Q

How long does biliary colic last?

A

About an hour

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28
Q

Where is biliary colic located?

A

RUQ

29
Q

Where can biliary colic radiate to?

A

right shoulder

30
Q

When does biliary colic occur?

A

Roughly 3-6 hours after a fatty meal has been consumed

31
Q

What does a patient present with during biliary colic pain?

A

Tachycardia
Diaphoresis
Epigastric pain

32
Q

Why does a patient with cholelithiasis look jaundice?

A

Bile cannot flow into duodenum

33
Q

What does the urine look like of a patient with cholelithiasis?

A

Dark amber color that foams when shaken

34
Q

What causes a patient’s urine to look like that with cholelithiasis?

A

Soluble bilirubin in urine

35
Q

What color are the stools of a patient with cholelithiasis?

A

Clay colored

36
Q

Why do patients with cholelithiasis have clay colored stools?

A

Bilirubin does not reach small intestine to be converted into urobilinogen

37
Q

What is steatorrhea?

A

Increased fat in stools

38
Q

Why does a patient with cholelithiasis have steatorrhea?

A

No bile salts in duodenum, preventing fat digestion

39
Q

Why does a patient with cholelithiasis have pruritis?

A

Deposit of bile salts into skin tissues

40
Q

Why does a patient with cholelithiasis have an intolerance to fatty foods?

A

There is no bile in the small intestine to help with fat digestion

41
Q

Why does a patient with cholelithiasis have bleeding tendencies?

A

Decreased absorption of vitamin K

42
Q

What is needing for the absorption of vitamin K?

A

Bile

43
Q

Vitamin K is an essential to produce…

A

Clotting factors

44
Q

What type of vitamin is vitamin K?

A

Fat-soluble

45
Q

What labs might you see with a patient with cholelithiasis?

A

Prolonged INR
Prolonged PTT

46
Q

What does a patient with cholelithiasis have a prolonged INR and PTT?

A

Because they have decreased absorption of Vitamin K, which is needed to make clotting factors.

47
Q

What is the most common cause of cholecystitis?

A

Obstruction from gallstones and biliary sludge

48
Q

What are 5 other potential causes of cholecystitis?

A

Prolonged immbolity

Fasting

Bacterial infection

TPN

Diabetes mellitus

49
Q

If a patient is NPO for a long time, and they start to develop a fever it may be…

A

their gall bladder

50
Q

How does the pathogenesis of cholecystitis start?

A

Obstruction that causes inflammation

51
Q

When the gallbladder is inflamed it becomes… (3)

A

Edematous

Hyperemic

Distended

52
Q

Overtime if the inflammation continues, what will happen to the gallbladder?

A

Scarring and decreased function

53
Q

What are the s/s of cholecystitis?

A

Fever

N/V

Restlessness

Diaphoresis

colic pain

54
Q

With cholecystitis what will the lab value of bilirubin look like?

A

Increased (of conjugated bilirubin)

55
Q

What produces the conjugated bilirubin?

A

Liver

56
Q

Why does a patient with cholecystitis have elevated liver enzymes?

A

Backup of bile

57
Q

Will the liver enzymes of a patient with cholecystitis be high or low?

A

High

58
Q

Why does a patient with cholecystitis have leukocytosis?

A

Due to the inflammation process

59
Q

What is amylase?

A

A pancreatic enzyme that releases into the common bile duct

60
Q

When would we see damage to the pancreas in a patient who has cholecystitis

A

If the blockage is low enough in the common bile duct that it is blocking the pancreatic duct

61
Q

If a patient with cholecystitis has damage to their pancreas, what would we see an increase in?

A

Amylase

62
Q

With cholecystitis, if there is an infection it can lead to…

A

Peritonitis and death

63
Q

The peritoneum is supposed to be…

A

sterile

64
Q

What analgesic is typically prescribed for pain control concerning cholecystitis?

A

ketorolac (Toradol)

65
Q

What type of drug is given for the nausea and vomiting associated with cholecystitis?

A

Antiemetics

66
Q

Why are anticholinergics given to patients with cholecystitis?

A

To decrease gallbladder secretion and stop smooth muscle spasms

67
Q

Why are bile acids sometimes given to patients with cholecystitis?

A

To dissolve stones

68
Q

If a patient with cholecystitis can’t control their pain with ketorolac (Toradol), what would we bump them up to?

A

morphine

hydromorphone (dilaudid)

69
Q

Anticholinergics have the __ effect

A

drying

Pathopharmacology I (33 decks)

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