wk 6 9 - pathology of biliary tract and pancreas

Question 1

gallstones medical name

Answer 1

cholelithiasis

Question 2

what stimulates the release of bile from the gallbladder

Answer 2

CCK

Question 3

where is bile secreted

Answer 3

ampulla of vater (meeting common bile duct) and entering duodenum at the sphincter of oddi

Question 4

what causes the formation of gallstones

Answer 4

cholesterol stones - high cholesteron, impairs micelle formation

pigment stones - excess bilirubin, cannot be solubilised

Question 5

what is micelle formation

Answer 5

hydrophilic head and hydrophobic tails in lipids

Question 6

excess bilirubin is due to excesss

Answer 6

haemolysis

Question 7

when is haemolysis seen

Answer 7

haemolytic anaemias

Question 8

pigment or cholesterol stones are unlikely to be pure, or develop from the pathogenesis alone. what are some contributing factors 3

Answer 8

gallbladder ph
mucosal glycoproteins
infection/inflammation of biliary lining

Question 9

cholecystitis

Answer 9

inflammation of gallbladder

Question 10

likely causes of acute cholecystitis

Answer 10

gallstones

Question 11

acute cholestylttis may lead to

Answer 11

empyema
rupture
peritonitis

Question 12

how can boouts of acute cholecystitis lead to chronci

Answer 12

intense adhesions can develop over days

multiple inflammations could lead to wall thickening - total occlusion causing chronic

Question 13

which carcinoma is liver to occur in gallbladder

Answer 13

adenocarcinoma

altho rare

Question 14

2 diseases which cholangiocarcinoma is associrred with

Answer 14

UC

PSC

Question 15

how would cholangiocarcinoma present

Answer 15

obstructive jaundice

Question 16

densely packed small glands in a fibrous stroma

this describes

Answer 16

cholangiocarcinoma

Question 17

a patient with elevated serum amylase, severly shocked with intense RUQ pain is likely to be

Answer 17

acute pancreatitis

Question 18

cholelithiasis

Answer 18

formation of gallstones

Question 19

acute pancreatitis can be due to bile reflux from duct obstruction due to a stone damaging the sphincte rof oddi, causing epithelial damage. what does this cause leading to pancreatiti

Answer 19

loss of protective barrier, allows autodigestion of pancreatic acini

Question 20

autodigestion of pancreatic acini leads to the release of what? what does this cause

Answer 20

proteases and lipases
protease - tissue destruction + haemorrhage
lipase - intra/peripancreatic fat necrosis

Question 21

for mild,mod,severe acute pancreatitis, outline what would be found on biopsy

Answer 21

mild - focal areas of necrosis in body of pancreas, superficial
mod - intrapancreatic fat necrosis
severe - complete pancreatic destruction, with haemorrhage and fat necrosis

Question 22

possible complications of acute pancreatitis 6

Answer 22

pseudocyst formation 
abscess formation 
hypocalcemia#
hyperglycemia 
shock 
death

Question 23

chronic pancreatitis can develop from

Answer 23

alcohol abuse 
cholelithiasis 
cystic fibrosis 
hyperparathyroidism 
genetics

Question 24

chronic pancreatitis is the replacement of pancreas to chronic inflammation and scar tissue, what doez this destroy?

Answer 24

destructioon of exocrine acini and islets (insulin secreting cell)