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Gastrointestinal
Gallbladder
30
Medical
Graduate
01/10/2010

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Cards

Term
The cystic duct joins with the ______ to form the _______.
Definition
Common hepatic duct. Common bile duct.
Term
The commmon bile duct coverges with the _______ to empty into the second part of the duodenum via the ______.
Definition
Pancreatic duct. Ampulla of Vater.
Term
The ingestion of fat triggers the release of which hormone, which causes the gallbladder to contrat and sphincter of Oddi to relax allowing bile to enter the intestines?
Definition
Cholecystokinin (CCK)
Term
What is the function of bile?
Definition
Alkalizes chyme and allows digestion of fats and fat soluble vitamins.
Term
What is the most common type of gallstone in the western population, comprising 75% of cases?
Definition
Mixed type containing a high level of cholesterol
Term
20% of gall stones are which type?
Definition
Pigmented stones, small dark stones made of bilirubin and Ca salts found in bile
Term
Which type of gallstone is radiopaque?
Definition
Pigmented stones
Term
What are the 4 F's of gallstone disease?
Definition
Female, fat, fertile, and forty
Term
Name 5 major risk factors of gallstones.
Definition
1)Obesity 2)Multiparity 3)High estrogen BCP 4)Chol. lowering meds 5)Rapid wt loss
Term
What is biliary colic? What type of gallbladder dz is it typically a sx of?
Definition
Dull pain in RUQ or epigastrium that may radiate to the back. Chronic cholecystitis.
Term
When does pain in chronic cholecystitis typ. occur? How long does it last and what causes it?
Definition
Typ. /p a meal, particularly high fat. Lasts 1-4hrs caused by temp. block of the GB by a stone.
Term
Describe pain experienced in acute cholecystitis.
Definition
Sharp, steady, well-localized pain in RUQ or epigastrium lasting >3-4hrs
Term
Dull, vague, or insignificant upper abd pain w/ wt loss suggests what?
Definition
Malignancy
Term
Distinguish between a pt experiencing biliary colic and a pt experiencing inflammation type pain.
Definition
Biliary colic - doubled up and restless. Inflammation - pt is very still.
Term
What physical finding, present in acute cholecystitis, is inhibition of inspiration upon palpation of the RUQ d/t pain?
Definition
Murphy's sign
Term
What lab value can be elevated if the cystic duct is blocked?
Definition
Alk phos
Term
What lab values are elevated in biliary obstruction?
Definition
AST, ALT, and dbili
Term
What abnormal lab value suggests inflammation and infection?
Definition
Leukocytosis w/ left shift
Term
What is the initial study of choice for suspected gallbladder dz?
Definition
US
Term
What test can be used to identify cause and level of biliary obstruction and to identify neoplasm?
Definition
CT scan
Term
A diagnostic test for gallbladder disease in which an raqdiopaque dye is injected and is excreted by the liver into bile in high concentrations.
Definition
HIDA scan
Term
A diagnostic test in which dye is injected through the skin via a needle into the intrahepatic bile ducts to visualize the proximal ducts, cytologic diagnosis, extract stines, and place biliary drainage catheter.
Definition
Percutaneous transhepatic cholangiogram (PTC)
Term
How are most bile duct stones removed?
Definition
Through ERCP
Term
Biliary colic with chronic cholecystitis.
Definition
Chronic cholecystitis
Term
What sx occur with chronic cholecystitis?
Definition
N/V w/ pain, intolerance to fatty foods, dyspepsia
Term
Chronic cholecystitis can be differentitated from acute by absence of ____ or ______.
Definition
fever or leukocystitis
Term
Gasllstone blocking the common bile duct.
Definition
Choledocholithiasis
Term
What clinical signs occur in choledocholithiasis?
Definition
Jaundice w/ light-colored stools and dark, tea-colored urine
Term
What is Charcot's triad? What condition does it occur in?
Definition
Jaundice, RUQ pain, and fever/chills. Acute cholangitis.
Term
Hypotension and mental confusion added to the sx of Charcot's triad is called what? What condition causes these sx?
Definition
Reynold's pentad. Acute suppurative cholangitis - pus in the biliary ducts
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