Who is likely to have gallstones?
female
fat
forty
fertile
What genetics would be involved in gall stones?
Pima Indians
Native Americans
What can cause Gallstones
Genetics
rapid weight loss
cirrhosis
hypertriglyceridemia
gallbladder stasis
DM, TPN, Spinal cord injury,
O...
who is likely to have gallstones female fat forty fertile
what genetics would be involved in gall stones pima indians native americans
what can cause gallstones genetics rapid weight loss cirrhosis
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CPP - Gallstones - Exam 3
CPP - Gallstones - Exam 3
CPP - Gallstones - Exam 3
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CPP - Gallstones - Exam 3
Who is likely to have gallstones? - female
fat
forty
fertile
What genetics would be involved in gall stones? - Pima Indians
Native Americans
What can cause Gallstones - Genetics
rapid weight loss
cirrhosis
hypertriglyceridemia
gallbladder stasis
DM, TPN, Spinal cord injury,
Octreotide (remember this is Sand statin a somatostatin analog typically used for ZES)
Is there a role for prophylactic cholecystectomy? - NO because In patients noted to
have asymptomatic cholelithiasis only 20% of those will become symptomatic within 15
years
What's a precursor to gallstones? - Biliary Sludge
What causes biliary sludge? - supersaturation point is reached, thus substances fall out
of solution and become trapped in gallbladder mucus and make sludge
What's the biggest contributing substance to biliary sludge? - Cholesterol
If the sludge continues to grow and fuses what happens? - a gallstone
Define gallstone disease? - When the gallstones become symptomatic
Are gallstone disease and acute cholecystitis the same? - NO
What are the complications of Gallstone Disease? - acute cholecystitis,
choledocholithiasis, acute cholangitis, gallstone pancreatitis
What will lab tests show you for Gallstone disease? - Nothing
they're normal
What is Biliary Colic? - CONSTANT NON-REPRODUCIBLE (not made worse with
movement)
, Dull, achy, RUQ/Epigastric pain associated with Gallstone Disease
can have n/v/d
Where might Biliary colic radiate? - Right
back
How long might Biliary colic last - usually 30 min and plateaus within 1 hour
entire attack lasts less than 6 hours
What causes Biliary Colic? - The Gallbladder contracting in response to stimulation
which forces the sludge or stone against the cystic duct increasing pressure in the
gallbladder
when would Biliary Colic occur? - after a fatty meal ingestion
nocturnally
What are atypical s/s of Biliary Colic? - CP
ABD pain/distension/bloating
Belching
fluid regurgitation
retrosternal burning
n/v and no biliary colic
What imagery test is used to find gallstones? - Ultrasound
What should be done before imaging ? - fasting
In patients you expected to find gallstones and didn't, what should you do? Why? -
repeat the transabdominal ultrasound within a few weeks
small stones are easily missed
What's the other testing option to find gallstone? What does it show? - cholecystography
with CCK stimulation which shows the ejection fraction and can indicate a gall bladder
disease origin
What should be on your DDX for Gallstones? - GERD
PUD
Hepatitis
Pancreatitis
IBS
Pyelonephritis
What can differentiate between your DDX for Gallstones? - lab testing
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