Pathophysiology of the Gall Bladder and Biliary Tree Flashcards Preview

MS2 - Digestive, Endocrine, and Metabolic Systems > Pathophysiology of the Gall Bladder and Biliary Tree > Flashcards

Flashcards in Pathophysiology of the Gall Bladder and Biliary Tree Deck (20)
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1
Q

What are the two functions of the gallbladder?

A
  • Store bile made by the liver

- Contract to deliver bile to the duodenum after a fatty meal

2
Q

Gallstones almost always develop in the ____________.

A

gallbladder

3
Q

What are gallstones most commonly composed of?

A

Cholesterol

There are also brown stones, which indicate infection.

4
Q

Describe the differences between the consistencies of cholesterol gallstones and pigment stones.

A

Cholesterol: like toothpaste
Pigment: brittle

5
Q

What are the five Fs of gallstone risk factors?

A
Fat
Forty
Female
Fertile (estrogen use) 
Family history
6
Q

An overweight, Hispanic female presents to your office with complaints of intermittent pain –particularly after fatty meals –that lasts for about five hours. What is the cause?

A

Movement of gallstones through the cystic duct and common hepatic duct

7
Q

How would you treat biliary colic?

A

Remove the gallbladder

8
Q

What causes cholecystitis?

A

There can be calculous and acalculous causes.

Calculous: duct is blocked by stone, gallbladder gets infected

Acalculous: usually ischemia (from sepsis, surgery, trauma, vasculitis, or hypotension)

9
Q

What distinguishes choledocholithiasis from calculous cholecystitis?

A

Choledocholithiasis is a stone in the common bile duct –meaning it blocks the liver, too. Patients will have jaundice.

10
Q

Bacterial infection of the bile duct is called ____________.

A

ascending cholangitis (almost always due to choledocholithiasis)

11
Q

A patient comes in with RUQ pain, fever, jaundice – (Charcot’s triad) – hypotension, and altered mental status – (Reynold’s pentad). What procedure will they likely need?

A

Urgent endoscopic retrograde cholangiopancreatography

12
Q

What transaminase pattern will be found in someone with biliary stricture?

A

ALTs greater than ASTs

13
Q

Cholangiocarcinoma is ___________.

A

adenocarcinoma of the bile duct

14
Q

Why do you need to regularly monitor patients with primary sclerosing cholangitis?

A

Because PSC increases risk of developing cholangiocarcinoma

15
Q

Pigment stones are primarily composed of ___________.

A

bilirubin

16
Q

Which kind of stones develop in the bile duct?

A

Brown stones

17
Q

What is biliary colic?

A

Pain resulting from irritation of the bile duct, usually due to passage of stones

18
Q

What is Mirizzi’s syndrome?

A

An occlusion of the cystic duct that leads to regional edema that causes blockage of the hepatic duct, as well

19
Q

How are biliary strictures treated?

A

ERGP with dilation

Biopsy for suspected malignancy

20
Q

Describe sphincter of Oddi dysfunction.

A

The SOD doesn’t open as much as it should or when it should, leading to symptoms that mimic choledocholithiasis. More common in women. Symptoms are intermittent.

Decks in MS2 - Digestive, Endocrine, and Metabolic Systems Class (133):