Gallbladder & Biliary System

Question 1

Where is the GB located?

Answer 1

Posterior to the right liver

Question 2

Function of GB

Answer 2

Used to store and concentrate bile that’s produce by the liver

Question 3

How is the GB connected to the Biliary Tree

Answer 3

By cystic duct

Question 4

What is the most depend portion of the GB

Answer 4

Fundus and MC location for storage

Question 5

How does the GB gets bloody supply

Answer 5

VIA cystis Artery

Question 6

Where is Cholecystokinin produce and what’s its purpose to the GB

Answer 6

Produce in the duodenum and caused GB to contract

Question 7

What is MC variant is the GB

Answer 7

Phrygian Cap and fold @Fundus

Question 8

Hartman’s Pouch

Answer 8

Outpouching of GB neck

Question 9

Junctional Fold

Answer 9

Prominent fold located at the junction of the gallbladder’s neck

Question 10

Cholelithiasis ( gallstone) mix with

Answer 10

Cortisol, calcium, bilirubinate, and calcium carbonate

• Wes sign

Question 11

What are the 6F associated with gallstone

Answer 11

1. Fat
2. Female
   3.fertile
   4.forty
3. Fair
   6.Flatulent

Question 12

Gallbladder Sludge

Answer 12

Associated with Bile stasis ( which is when the bile is stagnant in the gallbladder

Thicken fudge or mimic a mass known as TUMEFACTIVE sludge

Question 13

Gallbladder polyp

Answer 13

Greater than 10 mm
A projection of tissue from the gallbladder wall into the lumen hyperechoic non-shadowing non-mobile projection tissue
Ball to the wall sign

Question 14

What is see with gallbladder polyps

Answer 14

Cholesterolosis (strawberry GB)
Hyperplastic CHOLECYSTIC, a group of proliferative and degenerative gallbladder disorder including adenomyomatosis and CHOLESTEROLOSIS

Question 15

Adendomyomatosis

Answer 15

It’s a form of hyperplastic cholesterolsis
The condition of the gland within the muscle of the gallbladder

Question 16

What is produced by Adendomyomatosis

Answer 16

Rokitamsky-Anshoff Sinuses
R-echogenic
A-adenomysosis
S- stone and sludge

Muscular layer thickened and producing diverticuli or tiny pockets

Question 17

Acute cholecystitis

Answer 17

Inflammation of the gallbladder

Most common cause of gallstone in cystic duct or gallbladder neck

-Sludge or fluid scene thick wall

Question 18

Gangrenous Cholecystitis

Answer 18

A direct evolution of acute cholecystitis

Bulging of the gallbladder wall, puss within the gallbladder

Question 19

Emphysematous Choleystitis

Answer 19

Gas or bubble in the gallbladder
Caused by infection
Dirty shadow, reverberation, ring down know as champagne sign

Seen in diabetic patients

Question 20

Chronic cholecystitis

Answer 20

Obstruction of the cystic duct

Intolerance of fatty food non-tender gallbladder Wes sign, thicken wall

Question 21

Acalculous Cholecystitis

Answer 21

No gallstone presenting
Positive Murph sign
Sludge and fluid, pain

Question 22

Gallbladder perforation

Answer 22

Perforated or raptor gallbladder
Irregular shaped gallbladder may tear

Question 23

Gallbladder enlargement

Answer 23

Greater than 8 to 10 cm in length

Question 24

Hydronic GB

Answer 24

Enlargement of GB indicate obstruction caused by blockage of cystic duct or billy tree

Question 25

Conrvoiser GB

Answer 25

Enlargement caused by a mass at pancreas head and Billary tree known

Question 26

Porcelain Gb

Answer 26

Classification at wall West sign Posterior wall is obscured by shadowing gallstone The poster will help differentiate between PORCELAIN gallbladder from West sign

Question 27

Gallbladder cancer

Answer 27

Most common cancer in the biliary tree, very rare Caused by chronic irritation of the gallbladder wall associated with gallstones and masses Suffer from chronic cholecystitis 

Question 28

Lab values for biliary obstruction

Answer 28

Alkaline phosphate Conjugate direct bilirubin Gamma glutml transpeptidase

Question 29

Two signs indicate inhepatic ductal dedication

Answer 29

Shotgun sign parallel and channel sig seen adjacent to the PV

Question 30

Mirizzi syndrome

Answer 30



Question 31

What is known as supportive cholecystitis

Answer 31

Empyema which is a differential diagnosis from GANGRENOUS CHOLECYSTITIS

Question 32

What the order of bile

Answer 32

liver-biliary radicle-rt or lt hepatic duct- CHD-Cyst Duct -GB - CBD - Ampulla of Vater- sphincter of oddi - duodenum

Question 33

What is Bile?

Answer 33

Digestive fluid produce by the liver

Question 34

Function of the Bile

Answer 34

Provide a conduit for a bile to drain from the liver into the small intestine

Question 35

Portal Triads

Answer 35

Hepatic Artery portal Vien Intrahepatic duct or CBD

Question 36

What does the Cystic duct contain?

Answer 36

Spiral valve of heister

Question 37

What’s does the sphincter of oddi

Answer 37

Opening allows panc. Juice to flow in duoduem

Question 38

Size of CBD

Answer 38

6mm or Less

Question 39

When is the intreahepatic duct dialated

Answer 39

Greater then 2mm

Question 40

What is seen wil intrahepatic dilatation

Answer 40

Shot gun sign or parallel tube sign enlargement of Common duct Double duct sign dilation of the CBD and panc duct

Question 41

Biliary Obstruction

Answer 41

Proximal biliary tree closet to the liver & distal is near panc head

Question 42

What is MC area for biliary obstruction

Answer 42

Distal CBD

Question 43

What is the MC cause of obstruction in agh

Answer 43

Gallstone

Question 44

Choledocholithoasis

Answer 44

Blockage of CBD by gallstone Biliary stasis - bike development into sludge or stone - bile is stagnant

Question 46

What’s is the mc cause of obstructive jaundice

Answer 46

Gallstone with in CBD

Question 47

Where are most stone located

Answer 47

Near ampulls of vater

Question 48

Mirizzi Syndrome

Answer 48

Stone in the cystic duct and the pt has jaundice

Question 49

Cholangitis

Answer 49

Inflammation of biliary ducts Wall thicken > 5mm

Question 50

What the Charcot Triad

Answer 50

Fever jaundice RUQ PAIN

Question 51

Prolonged acute Cholangitid can cause

Answer 51

Pneumobilia

Question 52

Pneumobilia

Answer 52

Air within the biliary tree Ring down appearance

Question 53

What is Pneumobilia see with

Answer 53

Surgery Emphysematous gb Prolonged acute choleystitis

Question 54

Ascariasis

Answer 54

Infection of the small intestine cause by ascaris lumbricodies - a parasitic roundworm

Question 55

Cholangiocarcinoma

Answer 55

Primary biliary tree cancer

Question 56

What is the MC risk factor of Cholangiocarcinoma

Answer 56

Primary sclerosis cholangitis Store and infection increase the chances

Question 57

What is Klatskin Tumor?

Answer 57

Mc manifestation of Cholangiocarcinoma

Question 58

Where is the Klatskin tumor located

Answer 58

Junction of rt and lt hepatic duct Pt has jaundice, pruritus, weight loss

Question 59

Biliary Atresia

Answer 59

Viral infection @ birth Nortowing or obiliteration of all or portion of the biliary tree Absent biliary duct

Question 60

Choledochal cyst

Answer 60

Mc type is cystic dilation of CBD Cystic mass near porta hepatic

Question 61

Caroli Disease

Answer 61

Dilation of intrahepatic duct, associated with renal disease Charocot Triad Central sign