Gallbladder and Biliary Tract - Pathoma Flashcards Preview

GI Week 5 - WLB > Gallbladder and Biliary Tract - Pathoma > Flashcards

Flashcards in Gallbladder and Biliary Tract - Pathoma Deck (14)
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1
Q

What is biliary atresia?

A

failure to form or early destruction of extrahepatic biliary tree

2
Q

What happens within the first three months of life if a patient has biliary atresia?

A

biliary obstruction

3
Q

How does biliary atresia present?

A
  • Jaundice
    • conjugated bilirubin
  • Cirrhosis
    • backflow damage
4
Q

What is Cholelithiasis?

A

solid, round stones in the gallbladder

5
Q

What is Cholelithiasis due to?

A
  • Precipitation of cholesterol or bilirubin in the bile
    • supersaturation (high concentration)
    • decreased phospholipids (e.g. lecithin) or bile acids (lose ability to solubilize)
    • stasis
6
Q

Are cholesterol stones usually radiolucent or opaque?

A

Usually radiolucent!

(don’t show up on x-ray)

7
Q

What are the risk factors for cholesterol stones in Cholelithiasis?

A
  • Age
  • Estrogen (increases activity of HMG-CoA reductase)
  • Clofibrate (lipid lowering agent)
  • Native American ethnicity
  • Crohn disease
  • Cirrhosis
8
Q

Are bilirubin stones radiolucent or radiopaque?

A

Radiopaque

(show up on x-ray)

9
Q

What are the risk factors for bilirubin stones in Cholelithiasis?

A
  • Extravascular hemolysis
    • produce large amount of unconjugated bilirubin
  • Biliary tract infection
    • can de-conjugate bilirubin
    • e.g. E.coli, Ascaris lumbricoides, Clonorchis sinesis
10
Q

What are the 5 key complications that can result from Gallstones?

A
  • Biliary colic
    • due to gallbladder contraction against stone
  • Acute and chronic cholecystitis
    • inflammation of gallbladder wall (ischemia and bacteria overgrowth)
  • Ascending cholangitis
    • usually enteric gram-negative bacteria
  • Gallstone ileus
    • gallstone obstruct small bowel
  • Gallbladder cancer
    • adenocarcinoma
11
Q

Where does the RUQ pain in Cholecystitis radiate to?

A

Right Scapula

12
Q

What is Porcelain gallbladder?

A

Calcified gallbladder due to chronic cholecystitis.

13
Q

What condition increases the incidence of Ascending Cholangitis?

A

Choledocholithiasis

14
Q

How does Gallbladder Carcinoma classically present?

A

Cholecystitis in elderly woman

(increased risk if porcelain gallbladder)

poor prognosis