Ucsf: Video B 12 Part 3 Ultrasound Abdomen (Gallbladder And Biliary Disease)

Front 1

What is considered diffuse GB wall thickening

Back 1

wall thickening that is greater than 3 mm

Front 2

What is the DDX of diffuse GB wall thickening
4

Back 2

edematous states
inflammatory states
AIDS
Neoplasm
Misc

Front 3

What are some causes of edematous states which result in Gall bladder wall thickening
4

Back 3

CHF, Renal failure, cirrhosis, hypoalbunemia

Front 4

What are some inflammatory states that cause GB wall thickening
5

Back 4

cholecystitis, hepatitis, pancreatitis, perforated DU, diverticulitis

Front 5

What are the major neoplastic causes of diffuse GB wall thickening
2

Back 5

adenoca, METS

Front 6

What are 2 misc causes of GB wall thickening

Back 6

varices, and adenomyomatosis

Front 7

During what phase of digestion would the GB be expected to be thickened

Back 7

post prandial

Front 8

What causes diffuse gallbladder wall thickening in HIV

Back 8

AIDS cholangiopathy

Front 9

Does aids cholangiopathy have increased flow in the thickened GB

Back 9

yes

Front 10

Can diffuse GB wall thickening happen in hepatitis without cirrhosis

Back 10

yes

Front 11

What are 4 risk factors for cholelithiasis

Back 11

female, obese, DM, pregnancy

Front 12

What are 4 complications of cholelithiasis

Back 12

acute cholecystitis
GB gangrene
GB perf
Gallstone ileus

Front 13

What are 3 classic characteristics of Gallstones

Back 13

echogenic
posterior acoustic shadowing
mobile (mostly)

Front 14

What is a common pitfall and often mistaken for cholelithiasis

Back 14

a gas bubble in the doudenum

Front 15

What helps to differentiate a gas

Back 15

it will have dirty shadowing

Front 16

What is the measurement of a distended GB

Back 16

>4cm

Front 17

What are 6 clues that a pt has cholecystitis

Back 17

GB wall thickeness > 3mm
distended GB >4cm
gallstones or impacted stones at the neck
pericholecystic fluid
postive murphies
hyperemic GB wall

Front 18

Is there increased flow to the GB wall in cholecystis

Back 18

yes

Front 19

What is the PPV of a pt with a positive muphys sign and gallstones

Back 19

92%

Front 20

What are 3 potential complications of cholecystitis

Back 20

gangrene, perforation, emphysematous cholecystitis

Front 21

What does the GB look like in Gangrene

Back 21

bands of nonlayering intraluminal echogenic material , irregular wall, murphies absent in 2/3 of cases

Front 22

What % of pt with GB gangrene have a murphies sign

Back 22

only 1/3

Front 23

What are 2 major clues that a pt has emphsematous cholecystitis

Back 23

gas in the lumen and wall of GB

pneumobilia

Front 24

When does acalculous cholecystitis occur

Back 24

in the absence of stones;
critically ill pts or pts on TPN or HIV

Front 25

Do pts with acalculous cholecystitis have a positive murphies sign

Back 25

no, (like gangraneous cholecystitis)

Front 26

What are 4 causes of focal GB wall thickenening

Back 26

adenomyomatosis
polyps
Varices
GB carcinoma

Front 27

What mimics focal GB wall thickening

Back 27

tumefactive sludge, adherent stones

Front 28

How do you differentiate a GB polyp from sludge

Back 28

it will have flow

Front 29

What are 50% of GB wall polyps

Back 29

cholesterol polyps

Front 30

What are the 6 S's of increased risk of malignancy for GB polyps

Back 30

size greater than 1cm
greater than 60
Single
Sessile
GallStones
Rapid Size increase