Gallbladder

Question 1

Cause of Gallbladder Dysfunction

Answer 1

Motility disturbances of gallbladder –> bile stasis –> stone formation (cholesterol stones)

Question 2

Patho of Gallbladder Dysfunction

Answer 2

Biliary sludge (bile salts, pigments, cholesterol, lecithin –> precursor to gallstones
asymptomatic –> cholecystitis (cystic duct obstruction –> inflammation)
cholangitis (common bile duct inflammation)
obstruct common bile duct –> choledocholithiasis –> bile and bilirubin build up –> juandice, pruritus, dark urine, clay-colored stools, steatorrhea

Question 3

Symptoms of Gallbladder Dysfunction

Answer 3

BILIARY COLIE:
RUQ or epigastric pain (radiates –> right shoulder, scapula), nausea, vomiting –> Murphy’s sign (pain on inspiration w RUQ palpation)
CHOLECYSTITIS:
RUQ pain –> fever –> anorexia –> nausea –> vomiting –> eructations –> heartburn –> fullness after meals
CHOLEDOCHOLITHIASIS:
jaundice –> dark urine –> clay-colored stool –> pancreatitis

Question 4

Causes of Pancreatitis

Answer 4

Biliary tract disease (gallstones obstruct pancreatic duct, backup of digestive enzymes damage gland) + alcohol use disorder (ethanol –> premature activation of pancreatic enzymes inside the pancreas)

Question 5

Pathos of Pancreatitis

Answer 5

ACUTE:
digestive enzymes prematurely in pancreas –> auto digestion of gland tissue –> inflammation –> cellular destruction –> necrosis or hemorrhage
ALCOHOL:
increases viscosity of pancreas juice –> decreases bicarbonate –> protein plug formation –> blocks ducts –> injury –> necrotizing or hemorrhagic pancreatitis –> exocrine (digestive enzyme) + endocrine (insulin) deficiencies

Question 6

Symptoms of Pancreatitis

Answer 6

Epigastric pain (radiates to back), constant, worse w eating or laying flat
Nausea, vomiting, diarrhea, anorexia
Fever
Tachycardia
Hypotension
Dyspnea
Abdominal tenderness, guarding, distension, reduced bowel sounds
Cullen’s sign (periumbilical ecchymosis)
Grey Turner sign (flank ecchymosis)
retroperitoneal bleeding –> jaundice –> transient muscle spams (hypocalcemia)

Question 7

Causes of Chronic Pancreatitis

Answer 7

Long-term alcohol use
Hereditary
Cystic fibrosis
Hyperlipdemia

Question 8

Patho of Chronic Pancreatitis

Answer 8

Inflammatory –> fibrosis + calcification –> destroys exocrine (digestive) + endocrine (insulin)

Question 9

Symptoms of Chronic Pancreatitis

Answer 9

upper abdominal pain (radiating back, worse after meals or alcohol)
Weight loss
Steatorrhea (greasy, foul-smelling stools from fat malabsorption)

Question 10

Causes of Pancreatic Cancer

Answer 10

Smoking
Obesity
Diabetes mellitus
Chronic pancreatitis

Question 11

Patho of Pancreatic Cancer

Answer 11

Ductal adenocarcinomas in exocrine ducts (digestive), in pancreatic head
Lymphatic + vascular invasion –> metastasis (liver, peritoneum)

Question 12

Symptoms of Pancreatic

Answer 12

Jaundice
Body + Tail tumors:
back or epigastric pain