Cholecystitis and Pancreatitis Quiz

Gallbladder (cystic duct) obstruction by stone leads to inflammation/infection.
50-80% of cases are caused by E. coli.
Acute acalculous cholecystitis is more common in critically ill patients and is often caused by biliary stasis.
Chronic cholecystitis is often associated with gallstones and can lead to a thickened gallbladder wall.
MCC: cholelithiasis or alcohol abuse (chronic).

Can be caused by trauma, hyperlipidemia, drugs, hypercalcemia, penetrating peptic ulcers, or medications.
Chronic pancreatitis involves loss of endocrine function and damage to the gland (fibrosis, calcification, ductal inflammation).
Acute pancreatitis is often related to gallstones or alcohol use.
Severe tearing pain during bowel movements can accompany pancreatitis.
Symptoms include: upper abdominal pain radiating to the back, pain better with leaning forward or sitting, nausea and vomiting, dehydration/shock, and occasionally peritonitis.

Painful linear lesions in the distal anal canal.
Most commonly located in the posterior midline.
May involve the full thickness of the mucosa if left untreated.
Associated symptoms include painful bowel movements, bright red blood on stools or toilet paper, and chronic skin tags.

Caused by bacterial infection of anal ducts/glands.
Common symptoms: throbbing rectal pain, worsened by sitting, coughing, or bowel movements.
Usual pathogens are S. aureus and E. coli.
Usually located in the posterior midline.

Used to maintain weight loss and reduce obesity-related issues in cases where other methods have failed.
BMI > 40, or ≥35 with comorbid conditions.
Individuals should be psychologically stable to follow post-operative instructions.
Complications: regurgitation, prolapse, esophageal dilation, dumping syndrome.

Small Bowel Obstruction (SBO): Usually from adhesions, hernias, neoplasms, IBD, or volvulus.
Large Bowel Obstruction (LBO): Often from neoplasms, strictures, hernias, volvulus, or intussusception, fecal impaction.
Common symptoms: abdominal pain, distention, SBO has high-pitched tinkles, visible peristalsis, LBO has less active sounds
XR shows air fluid levels in step ladder patterns; CT if unclear.
Severe mechanical obstruction requires urgent surgical consultation.

Appendicitis most commonly occurs in individuals aged 10-30 years old.
Characteristic symptoms include anorexia, periumbilical pain that becomes constant and more severe in the RLQ (McBurney's point), nausea and vomiting, low-grade fever, rebound tenderness.
A 20% chance of perforation or peritonitis, which is severe generalized abdominal pain + increased WBC + fever.

Twisting of a loop of bowel
Most common location is the sigmoid colon.
Risk factors for cecum volvulus: chronic constipation, medications that inhibit gut motility, prior abdominal surgery.

Autoimmune, progressive cholestasis with diffuse fibrosis of the intrahepatic and extrahepatic ducts.
It is frequently associated with inflammatory bowel disease, most patients will have Ulcerative colitis.

Biliary tract infection caused by gallstone obstruction.
Commonly from choledocholithiasis.
Presentation of s/s may include RUQ pain, jaundice, fever.
Reynolds Pentad: Includes shock, altered mental status (AMS) with the Charcot's triad.

Increased frequency or volume of stools for ≥2-3 consecutive days.
Different types include inflammatory, secretory, osmotic (large volumes w/o inflammation) , and malabsorptive.
Inflammatory (bloody, w fever, dysentery) suggests invasive organisms or IBD.

Squamous cell carcinoma
Commonly associated with tobacco and alcohol use; decreased veggie and fruit consumption.
Adenocarcinoma
More common in younger patients.
MC in lower 1/3 of esophagus.
RF: GERD, Barrett's esophagus, obesity.

Complication of GERD/ Barrett's esophagus/ obesity that causes narrowing in the esophagus.

Adenocarcinoma is MC.
SQUAMOUS cell carcinoma is less common •RF: H. pylori, salted, cured, smoked, pickled foods. •S/s: dysphagia with solids, indigestion, weight loss, early satiety.

Decreased stool volume + increased stool firmness with straining.
Diverticulitis: Inflammation of diverticula, commonly in sigmoid & descending colon, caused by obstruction/fecaliths.