Cholelithiasis and Cholecystitis Overview
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Questions and Answers

What is a common clinical manifestation of cholecystitis?

  • Persistent headache
  • Severe pain radiating to the left shoulder
  • Steady ache in the left upper quadrant
  • Progressively worsening RUQ or epigastric pain (correct)

    • Which combination of therapies is appropriate for managing biliary colic?

  • Surgery and IV antibiotic therapy
  • Laparoscopic surgery and clay-colored stool monitoring
  • Oral dissolution therapy and antihistamines
  • Analgesics and antiemetics (correct)

    • Which symptom is most indicative of cholangitis?

  • Clay-colored stools (correct)
  • Fat intolerance
  • Acute onset of nausea
  • Severe RUQ tenderness only

    • In choledocholithiasis, what is a likely symptom?

    <p>Jaundice and abdominal tenderness</p> Signup and view all the answers

    What is a possible non-surgical treatment option for chronic cholecystitis if surgery is contraindicated?

    <p>Lithotripsy or oral dissolution therapy</p> Signup and view all the answers

    What characterizes the pain associated with cholelithiasis?

    <p>Abrupt onset, lasting 30 minutes to 5 hours</p> Signup and view all the answers

    Which symptom is more commonly associated with cholecystitis than with cholelithiasis?

    <p>Chills and fever</p> Signup and view all the answers

    What is a complication of cholelithiasis?

    <p>Common bile duct obstruction</p> Signup and view all the answers

    How does the pain from cholecystitis differ from that of cholelithiasis?

    <p>Cholecystitis pain is generalized in the abdomen</p> Signup and view all the answers

    Which of the following is NOT an associated symptom of cholecystitis?

    <p>Acid reflux</p> Signup and view all the answers

    What can happen if there is common bile duct obstruction associated with cholelithiasis?

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

    What is a notable difference in the duration of pain between cholecystitis and cholelithiasis?

    <p>Cholecystitis pain typically lasts 12–18 hours</p> Signup and view all the answers

    Which complication is specific to chronic cholecystitis?

    <p>Gallstone ileus</p> Signup and view all the answers

    What is the primary treatment for patients with symptomatic gallstones or acute cholecystitis?

    <p>Surgical removal of the gallbladder</p> Signup and view all the answers

    Ultrasonography of the gallbladder is less accurate than a CT scan for diagnosing cholelithiasis.

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

    Which diagnostic test can indicate obstructed bile flow by measuring direct bilirubin levels?

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

    The ________ scan uses an IV radioactive solution to diagnose cystic duct obstruction.

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

    Match the following diagnostic tests with their descriptions:

    <p>Serum amylase = Identifies possible pancreatitis Abdominal x-ray = Shows high calcium content gallstones Oral cholecystogram = Assesses gallbladder's ability to concentrate bile Gallbladder scan (HIDA) = Uses radioactive solution to evaluate biliary function</p> Signup and view all the answers

    Study Notes

    Cholelithiasis

    • Characterized by the presence of gallstones in the gallbladder.
    • Gallstones are hardened deposits of cholesterol, bile pigments, and calcium salts.
    • Symptoms:
      • Abrupt onset of severe, steady pain localized to the epigastrium and right upper quadrant (RUQ) of the abdomen.
      • Radiates to the back, right scapula, and shoulder.
      • Pain lasts for 30 minutes to 5 hours.
      • Aggravated by movement and breathing.
      • Associated symptoms: nausea, vomiting.
    • Complications:
      • Can lead to cholecystitis, common bile duct obstruction, pancreatitis, gangrene, perforation, peritonitis.
      • May result in chronic cholecystitis, empyema, fistula formation, and gallstone ileus.

    Cholecystitis

    • Inflammation of the gallbladder.
    • Caused by gallstones blocking the cystic duct.
    • Symptoms:
      • Abrupt onset of severe, steady pain in the right upper quadrant (RUQ) of the abdomen.
      • Pain lasts for 12 to 18 hours and is generalized in the RUQ.
      • Radiates to the back, right scapula, and shoulder.
      • Associated symptoms: anorexia, nausea, vomiting, RUQ tenderness and guarding, chills and fever.

    Biliary Colic

    • Caused by the passage of a gallstone through the cystic duct or common bile duct.
    • Symptoms:
      • Severe, steady ache in the RUQ that begins suddenly and lasts for several hours.
      • May radiate to the right scapula or back.
      • Nausea and vomiting are common.
      • Fat intolerance.
    • Treatment:
      • Analgesics for pain relief.
      • Adequate rest and nutrition.
      • Correction of electrolyte imbalances.
      • Antiemetics for nausea.
      • Surgery to remove the gallbladder (cholecystectomy) is the definitive treatment.

    Choledocholithiasis

    • Presence of gallstones in the common bile duct.
    • Symptoms:
      • RUQ pain.
      • Fever.
      • Jaundice (yellowing of the skin and eyes).
      • Pruritus (itching).
      • Abdominal tenderness.
    • Treatment:
      • Analgesics for pain relief.
      • Antihistamines for itching.
      • Adequate nutrition.
      • Antibiotics for infection.
      • Antiemetics for nausea.
      • Surgery to remove the gallstones.

    Cholangitis

    • Infection of the bile ducts.
    • Usually occurs in the presence of choledocholithiasis.
    • Symptoms:
      • RUQ pain.
      • Fever.
      • Jaundice.
      • Pruritus.
      • Abdominal tenderness.
      • Clay-colored stools.
      • Dark urine.
      • Low blood pressure.
      • Lethargy.
    • Treatment:
      • Aggressive intravenous antibiotics.
      • Antiemetics for nausea.
      • Surgery is often needed to remove the gallstones and drain the infected bile ducts.

    Treatment of Cholelithiasis and Cholecystitis

    • Treatment depends on the severity of the condition and the patient's health.
    • Asymptomatic patients with low complication risk are treated conservatively.
    • Surgical removal of the gallbladder is indicated for frequent symptoms, acute cholecystitis, or large stones.

    Diagnostic Tests

    • Tests identify stones, complications, and differentiate gallbladder disease from other disorders.
    • Elevated direct bilirubin suggests obstructed bile flow.
    • Elevated WBC count in CBC indicates infection and inflammation.
    • Serum amylase and lipase levels help diagnose pancreatitis related to common duct obstruction.
    • Abdominal x-ray can detect calcium-rich gallstones.
    • Ultrasonography accurately diagnoses cholelithiasis and assesses gallbladder emptying.
    • Oral cholecystogram assesses gallbladder's ability to concentrate and excrete bile.
    • Cholescintigraphy (HIDA scan) uses an IV radioactive solution to diagnose cystic duct obstruction and acute or chronic cholecystitis.

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    Description

    This quiz explores the key aspects of cholelithiasis and cholecystitis, including their symptoms, causes, and potential complications. It is designed for students studying gastrointestinal disorders or relevant medical fields. Test your knowledge on gallstones and gallbladder inflammation.

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