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