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58 Cards in this Set
- Front
- Back
_______ is gallstones
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cholelithiasis
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What are the 5 Fs
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Things assosciated with gallstones:
female fat fourty fertile fair skined |
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Stones are _______, _______, and _______
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mobile
echogenic shadowing |
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If a stone wont shadow _______
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go to a higher frequency
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_______ lies posterior to the GB and can be mistaken for stones
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duodenum
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Stones may be asymptomatic. What are some symptoms?
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sour taste in mouth, belching, pain by obstruction
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What is the WES sign
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Wall
Echo Shadow |
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_______ is extream dilation of the gallbladder
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hydrops - gallbladder will be palpable, pt has pain, NV
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What causes hydrops
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stone in cystic duct, trauma
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_______ is echogenic or viscous bile. it produces low level echoes attributed to thick or inspissated bile. Produced in any condition causing biliary stasis.
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Sludge
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Over time sludge can become sludge balls, or AKA _______
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TUMEFACTIVE SLUDGE
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What are some causes of a thickend (over 3mm) GB wall?
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Ascites, adenomyomatosis, cancer, AIDS, sclerosing cholangitis, diffuse liver disease, pancreatitis, portal hypertension, and heart failure
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_______ is acute inflammation of the GB. Usually results from obstruction of the neck of the GB or cystic duct.
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Acute cholecystitis
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What are the symptoms of Acute Colecystitis?
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RUQ pain radiates to back
elevated white blood cells fever n/v |
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_______ is on physical exam the patient is tender over the GB region. This indicates acute cholecystitis
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Murphy's Sign
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_______ is fluid around the GB that is an indicaton of acute cholecystitis.
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Pericholecystic fluid
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_______ is a rare complication of acute cholecystitis that is a stone impacted in the cystic duct or CHD and inflames the surrounding structures such as the CBD, causing biliary obstruction above the CBD level.
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Mirizzis Syndrome
(jaundice, pain, fever) |
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_______ is inflammation of the GB without presence of stones. Seriously ill patients, trauma, burns, sepsis, dehydration
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Acalculous Cholecystitis
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_______ is the result of multiple episodes of acute process. The GB appears contracted with many stones and thickened walls.
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Chronic cholecystitis
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_______ are small focal developmental lesions of the liver composed of groups of dilated intrahepatic bile ducts set within a dense collagenous stroma. benign less than 1 cm. Usually hypoechoic.
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Biliary Hamartomas aka Von Meyenburg complexes
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_______ is a stone in the ductal system which may cause the tree to dialte.
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Choledocholithiasis
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_______ is a congenital dilation of the biliary ducts. MC in females. Increased incident in infants.
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Choledochal Cysts - appears as a true cyst in the RUQ
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_______ is dilation of the CBD at the Ampulla of Vater
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Choledochocele
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_______ is a rare congenital condition in which the intrahepatic bile ducts are irregularly dilated with diverticulae like projections
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Carolis Disease
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_______ is inflammation of the bile ducts causing thickening of the ductal walls, biliary dilation adn trapping of air within the duct.
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Cholangitis
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_______ is a fatal condition that is MC in males and develops into cirrhosis and ductal carcinoma.
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Primary Sclerosing Cholangitis
(5 year survival rate) |
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what are the signs of Primary Sclerosing Cholangitis
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Inflamed Ducts, jaundice, itching, fatigue
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What are some clinical features of Primary Sclerosing Cholangitis?
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CBD wall thickening, WBC increased
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_______ occurs in middle aged females and is inflammatory destruction of the intrahepatic bile ducts. Destruction leads to a band of fibrosis form in a process of cirrhosis. Progression is not preventable.
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Primary Biliary Cirrhosis (liver transplant)
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_______ is gas in the biliary tree shadow.
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Pneumobilia
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Pneumobilia is often seen post _______
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ERCP, or surgery
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_______ is blood in the GB from GI bleed, trauma, endoscopy
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Hemobilia
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_______ is hyperplastic change in the GB wall. Diverticulum like pouches project from the thickend wall called Rokitansy Aschoff Sinuses.
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Adenomyomatosis (comet tail artifact seen) (mild RUQ pain)
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_______ results from abnormal metabolism of cholesterol within the GB wall.
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Cholesterolosis (strawberry GB)
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_______ is an abscessed GB containing pus and hemorrhagic debris.
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Empyema ( ill defined GB filled with heterogenous low level echos)
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What symptoms do patients with empyema have?
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if it leads to gangrene they may develop septicemia, fever, pain, NV
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_______ is a life threatening condition characterized by gas in the wall and lumen of the GB. MC in males. Can progress to gangrene and perforation.
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Emphysema
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_______ is a gallbladder that is completely calcigied. Increases GB carcinoma by 25%.
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Porcelain GB
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_______ may be found in the extrahepatic or intrahepatic ductal pathway. Caused by choledocholithiasis.
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Biliary Obstruction
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_______ is when the ducts outside the liver are enlarged. Caused by tumors of the CBD, ampulla and panc.
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Extrahepatic Ductal Dilation. Enlarged CBD, and panc duct
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_______ is when the ducts within the liver are enlarged.
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Intrahepatic Ductal Dilation
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_______ is rare. Seen in elderly. Fatal. Metz quickly.
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Carcinoma of the GB
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A polypoid growth greater than _______ should be questioned for GB carcinoma.
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1cm
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_______ is distended GB to the point of palpation caused by obstruction of the CBD caused by a malignant tumor in the panc head. Painless jaundice, and palpable RUQ mass.
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Courvoisier GB
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_______ is a malignant neoplasm arising from the bile ducts. Diagnosis poor. jandice, weight loss, thickened ductal wall. Soft tissue mass near the ducts.
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Chlangiocarcinoma
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What are the 3 types of chlangiocarcinoma?
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Polypoid, scirrhous, Klatskin tumor
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_______ develop within the CBD and cause extrensic obstruction
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Polypoid tumors
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_______ develop around the CBD and cause extrinsic obstruction
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Scirrhous tumors
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_______ ony causes intrahepatic dilation. Develops at the juncton of the right and left hepatic ducts. Slow growing. Metz late.
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Klatskins Tumor
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When are gallstones seen in children?
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usually with sickle cell, liver disease, bowel resectoin, cardiac shunts, hemolytic anemias, blood transfusions, RH incompatibility, cystic fibrosis, Crohns, dehydration, and sepsis
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_______ in the peds patient is usually diagnosed within the first few years of life
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choledochal cyst
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_______ is a rare obstructive disease seen in infants
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biliary atresia
(fatal if not treated by liver transplant or Kasai procedure) |
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_______ is when a segment of bowel is anastomosed to an exposed area of the liver
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Kasai procedure
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_______ is yellowing of the skin and eyes from excessive bili.
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Jaundice
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_______ results from breakdown of red blod cells with a consequent increase in bili.
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Hemolytic jaundice
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_______ relates to defective liver funtion
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hepatic jaundice
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_______ results from obstruction of the bile ducts, and is treated with surgery
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Obstructive jaundice
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What are the lab tests of the biliary system?
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total bili and alk phos: indicate biliary disorders.
Indirect bili: indicates a hemolytic process. RBC, AMY, LFTs |