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24 Cards in this Set
- Front
- Back
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What are the two types of stones?
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Mostly cholesterol
Mostly pigmented calcium bilirubinate |
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How is cholesterol eliminated?
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mainly through the bile
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How does cholesterol remain in solution?
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By mixing with bile salts and lecithins
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What are the conditions necessary for GB stone formation?
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1. Supersaturated with cholesterol
2. Nucleation 3. Enlargement |
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What structures can nucleate a stone?
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Nidus
Sloughed mucosa Bacteria Calcium salts Mucoproteins |
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What the F's of gallstones?
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Fat
Female Fair Forty Fertile |
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Why does rapid weight loss promote stone formation?
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Due to cholesterol dump into GIT
Fat has to go somewhere |
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What are the inborn disordes of bile acid metabolism that can promote stone formation?
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Crigler-Najjar
Gilbert Dubin-Johnson |
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Who typically develops pigmented stones?
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Asians with hemolysis and pts with cirrhosis
Generally, pts with lots of bilirubin |
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Where do pigmented stones arise?
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anywhere in the biliary tract
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Why are small stones more dangerous than large stones?
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Small stones can become stuck in cystic duct or the valves of Heister. Larger stones can't really move.
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What is the morphology of an acute cholecystitis?
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Enlarged tense gb filled with pus. Possibly gangrenous or hemorrhagic.
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What is the morphology of a chronic cholecystitis?
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thick wall with fibrosis and lymphocytic infiltration
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What is acute calculous cholecystitis?
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Small stone obstruction causing lysolecithin accumulation that is toxic to the mucosa.
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When would a surgeon remove a gallbladder with no stones?
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Acute acalculous cholecystitis
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What can cause acalculous cholecystitis?
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dehydration
gb stasis vascular compromise bacterial infection |
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What is chronic cholecystitis?
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term used to describe a gb with mucosal erosion and thickened walls. Stone not necessary, but most often present.
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What bugs cause cholangitis?
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Gram negatives
Group D streps Parasites |
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What is a stone in the common bile duct called?
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Choledocolithiasis
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What causes biliary atresia?
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possible inflammatory process with fibrosis
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What is the 5 year survival for carcinoma of the gb?
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1%
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What are most cancers of the gallbladder and extrahepatic ducts?
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adenocarcinomas
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What are the two types of adenocarcinomas found in the gb?
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papillary or infiltrating
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What is a strawberry gb?
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gb filled with foamy macrophages. Path autopsy term.
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