Gallstone

Question 1

Cause

Answer 1

Increase in choleterol and or bili
Decrease in bile salt
Stasis

Question 2

Cholesterol stone

Answer 2

Radiolucent (10-20% opaque due to calcification)
80% of stones

Associated with obesity, crohns’, CF, old age, clofibrate, estrogens, multiparity, rapid weight loss, native american

Question 3

Pigment stones

Answer 3

Radiopague

Seen in chronic hemolysis, alcoholic cirrhosis, advanced age, biliary infection

Balck: hemolysis
Brown: infection

Question 4

Complication

Answer 4

Often cause cholecystitis,
ascending cholangitis,
acute pancreatitis,
bile stasis

Question 5

Biliary colic

Answer 5

Neurohormonal activaiton (CCK after fatty meal)
Triggers contraction of the gallbladder, forcing stone into the cystic duct
May present without pain (in DM)

Question 6

Dx

Answer 6

US

Radionuclide biliary scan (HIDA)

Question 7

Cholecystitic

Answer 7

Inflammation of gallbladder
Usually from gallstones
Rarely from ischemia or infectious

Increase ALP if bile duct involved.