Shared Flashcard Set

Details

Gall Bladder and Bile Ducts
d
31
Medical
Graduate
12/19/2010

Additional Medical Flashcards

 


 

Cards

Term
What does Jaundice indicate?
Definition
You have too much bilirubin (hyperbilirubinema)
Term
Cholestasis
Definition
cessation of cile flow and accumulation of billiary substances in the blood.
Term

A 38 year old patient comes into the ER with scleral icterus. Biopsy reveals balooned hepatocytes with wispy cytoplasm and bile lakes in parenchyma. What is the diagnosis?

 

A)Cholestasis

B)Cholangiolitis

C)Cholangitis

D)Canalicular cholestasis

 

Definition
Cholestasis
Term

A patient comes in to your office with jaundice. After taiking a history you decide to get a biopsy which reveals portal tract edema, bile duct distention, periductular inflammation. What is the diagnosis?

A)Cholestasis

B)Cholangiolitis

C)Cholangitis

D)Canalicular cholestasis

Definition
Cholangiolitis
Term

As the hospital's pathologist you read a slide. You see many nuetrophils entering the bile ductular lumen iin great numbers along with some rod shapped gram positive structures. What is your diagnosis?

A)Cholestasis

B)Cholangiolitis

C)Cholangitis

D)Canalicular cholestasis

Definition
C- Cholangitis
Term
Ms. Peabody is a 54 year old women who presents with puritis and lupus. Laboratory tests reveal anti-mitochondrial antibodies.
Definition

1) autoimmune disorder of interlobular bile duct

2) causes chronic inflammation of intrahepatic bile ducts, destruction, and cirrhosis

3)

Term

A patient comes into the ER and biopsy reveals panacinar/multifocal necorosis. Which of the following would be considered as part of the differential?

A) Hepatocellular damage

B) cholate stasis

C)Pseudoxanthomatous

D)Canicular cholestasis

E) Biliary Fibrosis

 


 

Definition
A
Term
What is the pathological progression of cholestasis?
Definition
1) Canicular (perivenular)
2) Chronic (periportal)
3)Biliary Fibrosis
Term
What are some of the the causes of cholestasis?
Definition
1)Intrahepatic (hepatocellular or biliary)
2) Extrahepatic (pancreatobiliary)
3)Systemic (drugs)
Term
A patient comes in with cholestasis in caniculi and hepatocytes with abnormal portal tracts (portal paucity). What is the differential diagnosis?
Definition
1) PBC
2)PSC
3) Childhood symptomatic and nonsymptomatic bilary paucity
Term
Hanah, A 54 year old women comes into your office with a rash for the last couple of weeks. She has had and still has SLE. Her daughter who is a medical student brought her into see you because she notices yellow in her mother's eyes in the past few days. You do a biopsy, what do you expect to find?
Definition
A)Intrahepatic biliary atresia
B)Hemochromatosis and cirrhosis.
C.)Progressive destruction of interlobular and septal bile ducts with no polys but many lymphocytes.
D)concentric clean fibrosis around bile ducts with degeneration of bile duct epithelium and transformation of bile ducts into fibrous cords.
Term
Hanah, A 54 year old women comes into your office with a rash for the last couple of weeks. She has had and still has SLE. Her daughter who is a medical student brought her into see you because she notices yellow in her mother's eyes in the past few days. What do you expect to find from results of further testing that will help you confirm your suspicion?
Definition
A)Anti-mitochondrial antibodies and expression of HLA-DRw52a.
B) Anti-mitochondrial antibodies and expression of MHCII on bile duct epithelium.
C) Cooper deposition
D)You detect cholangocarcinoma
Term
Paul, a 42 year old plumber and a prostate cancer survivor presents with bouts of abdominal pain. His skin is mildly jaundiced. What do you expect to find on biopsy?
Definition
A)Intrahepatic biliary atresia
B)Hemochromatosis and cirrhosis.
C.)Progressive destruction of interlobular and septal bile ducts with no polys but many lymphocytes.
D)concentric clean fibrosis around bile ducts with degeneration of bile duct epithelium and transformation of bile ducts into fibrous cords.
Term
Paul, a 42 year old plumber and a prostate cancer survivor presents with bouts of abdominal pain (RUQ). He has noticed some weight loss and is worried that is cancer is back. His skin is mildly jaundiced. What our tests do you need to confirm your suspicion and make the diagnosis?
Definition
A)Granuloma formation
B) Test for copper deposition
C)Anti-mitochondrial DNA anitbodies
D) ERP and AMA
Term
What is Alagille’s syndrome?
Definition
The syndromatic form of intrahepatic biliary atresia (paucity of intrahepatic bile ducts). A cholestatic syndrome found in infancy and childhood.
Term
What are some complications of biliary atresia?
Definition
1) Xanthomas
2) Pigmentation of teeth
3)Alagille's syndrome
4)Giant Cell reaction
Term
What are some possible causes of gall stone formation?
Definition
(1) bile supersaturation with cholesterol,
(2) nucleation of cholesterol monohydrate with subsequent crystal retention and stone growth, and
(3) abnormal gallbladder motor function with delayed emptying and stasis
Term
What do jet black biliary gall stones indicate?
Definition
Chronic hemolysis
Term
Define Biliary colic
Definition
constant and long lasting pain that results from an obstruction of the cystic or common bile duct
Term
Patient's lab tests show an elevated bilirubin and alkaline phosphatase. What is the most common location of the patient's gall stone?
1) Cystic bile duct
2) Common Bile duct
3) Interhepatic bile duct
Definition
2
Term
What is a Calculus and what causes it?
Definition
Calculus (obstruction of cystic duct)
1)mechanical inflammation produced by increased intraluminal pressure and distention with resulting ischemia of the gallbladder mucosa and wall
2) chemical inflammation caused by the release of lysolecithin (due to the action of phospholipase on lecithin in bile) and other local tissue factors
3)bacterial inflammation, which may play a role in 50-85% of patients with acute cholecystitis
E. coli, Klebsiella, Streptococus, and Clostridium spp
Term
What causes Acalculus and how comon is ti compared to other acute colecystitises?
Definition
Acalculus (>50% an underlying explanation inflammation is not found, biliary sludge in some cases
associated with serious trauma or burns, the postpartum period, postoperative period, parenteral hyperalimentation, vasculitis, obstructing adenocarcinoma of the gallbladder, diabetes mellitus, torsion of the gallbladder
The complication rate for acalculous cholecystitis exceeds that for calculous cholecystitis
Term
Hank, a 65 year old man presents with chills, fever, rigor, and right upper quadrant pain. He has a history of Diabetes? Which of the following is the mostly likely diagnosis?
A) Pancreatitis
B)Emphysematous
C)Caliculus
D)Colangitis
1)
Definition
Emphysematous
acute cholecystitis (calculous or acalculous) followed by ischemia or gangrene of the gallbladder wall and infection by gas-producing organisms, ie, C. welchii or C. perfringens, E. coli
This condition occurs most frequently in elderly men and in patients with diabetes mellitus
Prompt surgical intervention coupled with appropriate antibiotics is mandatory
Term
What are Rokitansky - Aschoff Sinuses and in what condition are they found?
Definition
Outpouchings of the mucosa through the muscle of the gall bladder wall and are a characteristic, but not diagnostic, feature of chronic cholecystitis
Term
What are the complication of cholecystitis?
Definition
Empyema And Hydrops
Gangrene And Perforation
Fistula Formation And Gallstone Ileus
Porcelain gallbladder
Xanthogranulomatous inflammation
Term
Klatskin Tumor
Definition
Tumor of the gall bladder Notable for slow growth, marked sclerosis, and infrequent distal metastases
Term
What is the difference between Liver Cell adenoma and focal nodular hyperplasia?
Definition
1) Focal Nodular hyperplasia is smaller in size. focal nodular hyperplasia of the gall bladder is also nodular with a central scar.
2)Liver adenomas normally hemorrhage
Term
What are some causes of hepatocellular carcinoma?
Definition
Chemical carcinogens
product of the Aspergillus fungus, called aflatoxin B1
Hepatitis B and C
HBV-based HCC may arise from rounds of hepatic destruction with subsequent proliferation and not necessarily from frank cirrhosis
Cirrhosis
It is still not clear whether cirrhosis itself is a predisposing factor to the development of HCC or whether the underlying causes of the cirrhosis are actually the carcinogenic factors
Term
Wilson's disease
Definition
Autosomal recessive disorder of copper metabolism marked by accumulation of toxic levels of copper in the liver, brain and eye.
Defect may involve defective mobilization of copper from hepatocellular lysosomes for excretion into bile.
Term
Kayser-Fleischer ring
Definition
opthalmic cooper deposition in Wilson's disease
Term
A patient's lab results show eosinophillic inclusions on biopsy of the liver, and blood work shows low levels of protease inhibitor. Which of the following do you not have to worry about when managing this patient?
A) Neonatal hepatitis
B) Bile Thrombi
C) Cholestasis
D)Chronic hepatitis
E) Cirrhosis
Definition
B. All others are complications of alpha-1 antitrypsin deficiency.
Supporting users have an ad free experience!