Patho - Exam 6 Alterations In Function Of Gallbladder And Exocrine Pancreas

Front 1

bile:

Back 1

aka Gall
-made by the liver
-aid in lipid digestion
-bitter, alkaline, brownish-yellow or greenish-yellow fluid that is secreted by the liver, stored in the gallbladder, and discharged into the duodenum and aids in the emulsification, digestion, and absorption of fats

Front 2

gallbladder:

Back 2

-does NOT make bile, just stores it
-stimulation for release by cholecystokinin
-small, pear-shaped muscular sac, located under the right lobe of the liver, in which bile secreted by the liver is stored until needed by the body for digestion

Front 3

Functional anatomy of the pancreas:

Back 3

1. exocrine and endocrine gland
2. secretes amylase, lipase and trypsinogen
3. stimulated by cholecystokinin and seretin

Front 4

pancreatitis:

Back 4

inflammation of the pancreas caused by derangement of enzymes secreted into the gland

Front 5

3 disorders of the gallbladder:

Back 5

1. cholesterol gallstone formation
2. cholecystitis and cholelithiasis
3. acute cholecystitis

Front 6

3 causes of cholesterol gallstone formation:

Back 6

1. saturation of bile with cholesterol
2. nucleation (aggregation of crystals)
3. stone growth (stasis of bile in gallbladder)

Front 7

pancreas:

Back 7

-long, irregularly shaped gland in vertebrates, lying behind the stomach
-secretes pancreatic juice into the duodenum and insulin, glucagon, and somatostatin into the bloodstream

Front 8

pancreatic duct:

Back 8

aka Wirsung's canal
-excretory duct of the pancreas, extending through the gland from tail to head, where it empties into the duodenum

Front 9

sphincter of Oddi:

Back 9

-complex sphincter closing the duodenal orifice of the common bile duct

Front 10

chronic pancreatitis:

Back 10

-primarily in alcoholics
-caused by buildup of calcifications that destroy the parenchyma
-severe abdominal pain occurs
-Cystic fibrosis is most common cause of chronic pancreatitis in children

Front 11

4 Common conditions caused by chronic pancreatitis:

Back 11

1. Diabetes mellitus
2. malabsorption
3. weight loss
4. Vit K deficiency

Front 12

Dx of chronic pancreatitis:

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1. calcifications on xray
2. clinical picture and history
3. ERCP appearance "chain of lakes"
4. complications and symptoms similar to acute

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Tx of chronic pancreatitis:

Back 13

-pain control
-sphinterectomy
-stents
-surgery (fileting duct)
-pancreatic enzymes
-antacids, H2 antagonist
-management of diabetes

Front 14

3 disorders of the pancreas:

Back 14

1. actute pancreatitis
2. chronic pancreatitis
3. Cancers of pancreas and biliary tract

Front 15

acute pancreatitis:

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-rapid onset inflammation of the pancreas
-caused by biliary tract disease or alcohol (66%)
-overproduction of enzymes causing abdominal pain and tenderness
-can lead to circulatory collapse

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ERCP =

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Endoscopic Retrograde Cholangiopancreatography
-endoscopy of the biliary tree and the pancreatic duct
-by injection of contrast, an image of both structures can be formed on X-ray, facilitating the diagnosis of obstruction, Ex:gallstones

Front 17

Dx of acute pancreatitis:

Back 17

-abdominal pain and tenderness
-high levels of serum amylase and lipase
-"sentenial loop" on xray
-CT scan
-differential diagnosis

Front 18

Tx for acute pancreatitis:

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1. mild cases: NPO, suction, IV fluids
2. severe cases: necrosis, bacterial contamination, peritoneal lavage, laparotomy

Front 19

Complications of acute pancreatitis:

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1. edoscopic or surgical drainage of pseudocyst (from mass, infection, rupture, hemorrhage)
2. abscess
3. ascites caused by leakage into duct - removal by paracentesis or stent in duct
4. ERCP for radiologic evaluation, extraction of stones, sphincterectomy

Front 20

cholecystitis:

Back 20

-inflammation of the gall bladder, usually resulting from a gallstone obstructing the cystic duct

Front 21

cholelithiasis:

Back 21

-presence or formation of gallstones in the gallbladder or bile ducts

Front 22

biliary colic:

Back 22

-extreme cramping pain in the right upper abdomen, the area just below the chest. The pain is caused by gallstones in the gallbladder (an organ of the digestive system) or bile ducts (small tubes that drain bile from the liver into the gallbladder and small intestines)

Front 23

chronic cholecystitis:

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-long-standing inflammation of the gallbladder characterized by repeated attacks of pain (gallbladder attacks) over a prolonged period
-tx: avoid fatty foods

Front 24

acute cholecystitis:

Back 24

-sudden onset of inflammation of the gallbladder, resulting in severe, steady upper abdominal pain (biliary colic), which may occur repeatedly
-At least 95% of these pts have gallstones