32 Biliary System ANATOMY AND PHYSIOLOGY
51 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which artery branches off the right hepatic artery?

  • Portal vein
  • Cystic artery (correct)
  • Common hepatic artery
  • Gastroduodenal artery
  • Where is the cystic duct located in relation to the triangle of Calot?

  • Superior
  • Inferior
  • Lateral (correct)
  • Medial
  • Which vessels supply the hepatic and common bile duct at the 9- and 3-o'clock positions during ERCP?

  • Gastroduodenal and retroduodenal arteries (correct)
  • Left and right hepatic arteries
  • Right hepatic and common bile duct arteries
  • Splanchnic and celiac ganglion arteries
  • Which veins drain into the right branch of the portal vein?

    <p>Cystic veins</p> Signup and view all the answers

    From which trunk of the vagus do parasympathetic fibers come to the common bile duct?

    <p>Left (anterior) trunk</p> Signup and view all the answers

    What causes relaxation of the sphincter of Oddi?

    <p>Glucagon</p> Signup and view all the answers

    What is the primary pathology of Acalculous Cholecystitis?

    <p>Bile stasis leading to distention and ischemia</p> Signup and view all the answers

    What is the most common route of dissemination for bacterial infection of bile?

    <p>From the portal system</p> Signup and view all the answers

    What is the best treatment for common bile duct strictures due to chronic pancreatitis?

    <p>Choledochojejunostomy</p> Signup and view all the answers

    What is the primary cause of late postoperative biliary strictures following laparoscopic cholecystectomy?

    <p>Ischemia</p> Signup and view all the answers

    What is the primary treatment for emphysematous gallbladder disease?

    <p>Emergent cholecystectomy</p> Signup and view all the answers

    What is the best initial treatment for gallstone ileus causing small bowel obstruction?

    <p>Remove stone through enterotomy proximal to obstruction</p> Signup and view all the answers

    What is the most common site of obstruction in gallstone ileus?

    <p>Terminal ileum</p> Signup and view all the answers

    When is hepaticojejunostomy preferred for bile duct injuries that cause early symptoms?

    <p>&lt;= 7 days after injury</p> Signup and view all the answers

    What imaging study is preferred to define anatomy and look for mass in suspected bile duct strictures?

    <p>MRCP (magnetic resonance cholangiopancreatography)</p> Signup and view all the answers

    What should be done if fluid collection is present and bilious after laparoscopic cholecystectomy?

    <p>Percutaneous drainage into the collection</p> Signup and view all the answers

    What should be performed when persistent jaundice and cholangitis follow laparoscopic cholecystectomy?

    <p>Percutaneous drainage of fluid collection followed by ERCP with temporary stent placement</p> Signup and view all the answers

    What is the most common site of metastasis for gallbladder adenocarcinoma?

    <p>Liver</p> Signup and view all the answers

    Which condition is associated with abnormal reflux of pancreatic enzymes during uterine development?

    <p>Choledochal cysts</p> Signup and view all the answers

    What is the first test for diagnosing HEMOBILIA?

    <p>EGD</p> Signup and view all the answers

    What is the most common risk factor for gallbladder adenocarcinoma?

    <p>Porcelain gallbladder</p> Signup and view all the answers

    Which symptom is most commonly associated with BILE DUCT CANCER (CHOLANGIOCARCINOMA) in its early stages?

    <p>Painless jaundice</p> Signup and view all the answers

    Which condition can lead to portal hypertension and hepatic failure due to progressive fibrosis of intrahepatic and extrahepatic ducts?

    <p>Primary sclerosing cholangitis</p> Signup and view all the answers

    What is the #1 serious complication of cholangitis, related to sepsis?

    <p>Renal failure</p> Signup and view all the answers

    Which procedure is generally needed if ERCP fails in treating cholangitis?

    <p>PTC tube placement</p> Signup and view all the answers

    What is the first step in the treatment of cholangitis?

    <p>Fluid resuscitation and antibiotics</p> Signup and view all the answers

    What is the most common organism causing cholangitis?

    <p>E. coli</p> Signup and view all the answers

    Which condition can be associated with ulcerative colitis, pancreatitis, and diabetes?

    <p>Primary sclerosing cholangitis</p> Signup and view all the answers

    Which disease can be discovered incidentally after cholecystectomy?

    <p>Gallbladder adenocarcinoma</p> Signup and view all the answers

    What is the primary function of gallbladder bile?

    <p>Excretion of bilirubin and cholesterol</p> Signup and view all the answers

    Which hormone causes steady, tonic contraction of the gallbladder?

    <p>CCK</p> Signup and view all the answers

    What is the color of bile mostly due to?

    <p>Conjugated bilirubin</p> Signup and view all the answers

    What percentage of bile salts is actively resorbed in the terminal ileum?

    <p>50%</p> Signup and view all the answers

    Which type of gallstone is characterized by stasis, calcium nucleation, and increased water reabsorption from the gallbladder?

    <p>Nonpigmented stones</p> Signup and view all the answers

    What is the most common type of stone found in the United States?

    <p>Nonpigmented stones</p> Signup and view all the answers

    What is the highest sensitivity lab test for choledocholithiasis?

    <p>GGT</p> Signup and view all the answers

    Which finding on ultrasound is suggestive of acute cholecystitis?

    <p>&gt; 6 mm CBD diameter</p> Signup and view all the answers

    What is the most sensitive test for cholecystitis?

    <p>HIDA scan</p> Signup and view all the answers

    When is cholecystectomy indicated after a CCK-CS test?

    <p>If gallbladder is not seen</p> Signup and view all the answers

    What are the indications for emergent ERCP?

    <p>Jaundice and dilated CBD without gallstone pancreatitis</p> Signup and view all the answers

    What percentage of patients undergoing cholecystectomy will have a retained CBD stone?

    <p>&gt;5%</p> Signup and view all the answers

    Which type of shock is more likely to occur within the first 24 hours following laparoscopic cholecystectomy?

    <p>Hemorrhagic shock from clip that fell off cystic artery</p> Signup and view all the answers

    What is the high-risk criteria that necessitates cholecystectomy regardless of the size of gallbladder polyps?

    <p>Sessile (wide base) polyps</p> Signup and view all the answers

    What is the management approach for gallbladder polyps in the size range of 6–9 mm?

    <p>Annual ultrasound monitoring</p> Signup and view all the answers

    What is the benign type of tumor associated with the gallbladder, which carries a risk of causing cholecystitis?

    <p>Granular cell myoblastoma</p> Signup and view all the answers

    What is the syndrome characterized by compression of the common hepatic duct, often requiring cholecystectomy?

    <p>Mirizzi syndrome</p> Signup and view all the answers

    What medication has been associated with gallbladder sludging and cholestatic jaundice?

    <p>Ceftriaxone</p> Signup and view all the answers

    Which condition is NOT a high-risk criterion that necessitates cholecystectomy regardless of the size of gallbladder polyps?

    <p>Hyperplastic polyps</p> Signup and view all the answers

    Which type of bilirubin has a half-life of 18 days and takes a while to clear after long-standing jaundice?

    <p>$eta$ bilirubin</p> Signup and view all the answers

    What condition is NOT caused by adenomyomatosis, despite its association with the gallbladder?

    <p>$ ext{LLQ}$ pain</p> Signup and view all the answers

    "Cholesterol polyps" and "hyperplastic polyps" are examples of what type of gallbladder condition?

    <p>$ ext{Benign}$ polyps</p> Signup and view all the answers

    More Like This

    Acute Cholecystitis and PC Overview
    35 questions
    Cholecystectomy Methods Quiz
    5 questions
    Use Quizgecko on...
    Browser
    Browser