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Anatomy
Enzyme Secretion
Stones
Gallbladder
Other
100
The Cystic duct (lateral), CBD (medial), Liver (superior) compose the.......
What is the Triangle of Calot?
100
Rate limiting step in cholesterol synthesis?
What is HMG CoA reductase. HMG CoA --> (HMG CoA reductase) --> cholesterol --> (7 alpha hydroxylase) --> bile salts (acids)
100
Percentage of stones that are radiopaque?
What is 10%?
100
Patient resists deep inspiration with deep palpation to the RUQ secondary to pain.
What is Murphy's sign.
100
This syndrome describes compression of the common hepatic duct
What is Mirizzi syndrome. It can be caused by a stone in the gallbladder infundibulum or inflammation arising from the gallbladder or cystic duct extending to the hepatic duct, causing hepatic duct stricture.
200
Name of the small accessory bile ducts that course along the gallbladder fossa.
What is Ducts of Luschka?
200
The location for resorption of CONJUGATED bile salts?
What is Terminal ileum (50%)
200
Most common stone type in U.S.
What are Cholesterol stones? They account for 75% of GB stones in U.S. They are caused by stasis, calcium, increased water reabsorption from the gallbladder.
200
Gallbladder forms concentrated bile by active resorption of these two substances.
What is NaCL and water.
200
Combination of RUQ pain, fever, and jaundice.
What is Charcot's triad. Seen in patients with cholangitis. Reynolds' pentad adds AMS and shock.
300
Where does a replaced right hepatic artery arise from? Replaced Left?
What is Replaced right from SMA. What is Replaced Left from left gastric.
300
The location of passive resorption of NONCONJUGATED bile salts?
What is Small intestine (45%) and colon (5%)
300
Black pigmented stones are caused by the following conditions.
What are hemolytic disorders, cirrhosis, ileal resection, chronic TPN.
300
This is the most common cause of biliary strictures.
What is ischemia secondary to laparoscopic cholecystectomy. Other causes include chronic pancreatitis, gallbladder CA, bile duct CA.
300
Cholangiocarcinoma of bile duct at the junction of the right and left hepatic ducts
What is Klatskin's tumor. This is the most common location for cholangiocarcinoma. It is associated with the worst prognosis. Can try lobectomy and stenting of the contralateral bile duct if localized to either the right or left lobe.
400
Valves in the gallbladder
What is Spiral valves of Heister
400
Stimuli that causes increased bile excretion?
What is CCK, secretin, and vagal input.
400
Cause of brown pigment stones
What is infectious process.
400
Most common type of choledochal cyst is..... Describe the five type of choledochal cysts.
What is Type I. See PDF diagram.
400
Gas in gallbladder wall is usually secondary to which pathogen?
What is clostridium perfringens. These patients are more likely to perforate. Treatment is usually emergent cholecystectomy of percutaneous drainage if patient is unstable.
500
name of the epithelial invagination in the gallbladder wall.
What is Rokitansky-Aschoff sinuses. They are formed from increased gallbladder pressure. They are often associated with cholelithiasis and cholecystitis.
500
Stimuli that causes decreased bile excretion?
What is somatostain, sympathetic stimulation.
500
Most common pathogen to cause brown pigment stones.
What is E. Coli. It produces beta-glucuco=uronidase, which deconjugates bilirubin with formation of calcium bilirubinate.
500
Name three risk factors for development of cholangiocarcinoma.
What is C. sinensis infection, ulcerative colitis, choledochal cysts, primary sclerosing cholangitis, chronic bile duct infection. Early these patients present with painless jaundice. Late they present with weight loss, pruritus.
500
Classic symptom presentation of hemobilia.
What is UGI bleed, jaundice, and RUQ pain. Hemobilia is most often caused by a fistula between the bile duct and the hepatic arterial system. This is often the result of trauma or percutaneous instrumentation to the liver.