Chapter 10 Gallbladder/Biliary System

Does a pt. present with a fever and/or high WBC count if they have Cholecystitis?

The most common cause of biliary ductal obstruction is the presence of a ductal:

A positive Murphy sign is a clinical finding associated with:

A tech scans a GB and notices Rok-Aschoff sinuses w comet tail. The patient has nausea, vomiting, RUQ pain. Diagnosis?

What are 2 other labs typically elevated with biliary obstruction?

Adenomyomatosis (Hyperplastic change of the GB wall causing overgrowth of the mucosa)

Which one of the following best describes nonshadowing, low-amplitude echoes in a dependent gallbladder?

What is the main cause of ascariasis?

Are extrahepatic ducts located inside or outside the liver?

What condition is also knows as strawberry gallbladder?

Pneumobilia is the technical term for _____ in the biliary tree?

Term for stones in the bile duct?

The sonographic appearance of cholelithiasis is best described as:

How many possible causes of wall thickening to the Gallbladder?

Pancreatic Adenocarninoma

A patient presents to the clinic who has been on 6 mnth intermittent fasting regimen. What is the most likely diagnosis?

This patient presents with pain and trauma to the abdomen. They most likely have:

Klatskin’s tumor may be found in the:

What is known as the muscular “gatekeeper” that relaxes the allow bile/pancreatic enzymes to flow?

What is routinely measured where the Rt. Hepatic artery courses between the portal vein and the bile duck?

How does the gallbladder appear with findings of Hydrops/Mucocele?

The right and left hepatic ducts come together to form the __________.

Air within the biliary tree, secondary to common bile duct stents, is called:

Gangrenous Cholecystitis

Biliary Atresia is suspected in infants with jaundice.

The finding of an enlarged duct with a moving tube or parallel echogenic lines within the biliary tree is caused by:

What anatomy is represented by the number 1?

What is the term for a substance that is gravity dependent, non shadowing and echogenic?

What is the most common cause of biliary obstruction?

Term for a rare condition caused by weakness in the bile duct wall?

Gallbladder Sludge is made up of what two things?

The portal vein and hepatic artery flows in the bile ducts which direction from the liver?

The 2 most common lesions gallstones and carcinoma of the head of the pancreas cause _______?

Which syndrome is extrahepatic biliary obstruction due to an impaired stone in the cystic duct?

What is the WES sign short for?

What is represented by number 2?

Murthy’s Sign is demonstrated when ________ ?

How much should the gallbladder measure anterior to posterior in the transverse plane?

Which of the following is the most common treatment for gangrenous cholecystitis?

Cholesterol Polyps

Which of the following is not a cause of extrinsic thickening of the gallbladder wall? 

Patient presents with severe RUQ pain who had recent surgery. What is the most likely diagnosis?

The gallbladder is divided into what 3 parts?

At what age does the normal CBD diameter increase?

What is the name of the fold in the gallbladder that occurs between the body and fundus?

A thick calcified gallbladder wall describes which one of the following conditions?

What 4 areas should you evaluate when performing a gallbladder ultrasound?

A gallbladder attack may cause pain in the 

After 60 the normal CBD diameter increase how much per decade?

What two things are also known as Wirsung’s duct join and enter the duodenum at the Ampulla of Vater?

What is the purpose of changing the patient’s position during the exam?

The most common tumor sites that can spread carcinoma to the biliary tree include all of the following except:

What is the term for absence of the extraheptic biliary tree?

What part of the gallbladder is represented by number 3?

______ Adenocarcinoma is the most common cause of malignant neoplasm obstructing the biliary tree.

The normal diameter of the common hepatic duct is approximately ________ millimeters (mm).

What part of the gallbladder is represented by number 1?

What other diagnostic tests besides ultrasound may be performed if Choledocolithiasis is suspected?

What is represented by number 3?

The GB can be replaced by a mass in the sonographic appearance of GB carcinoma.

What is the name of the valve that controls the bile flow in the cystic duct?

Cholangitis is usually due to an infection _______?

Choledocolithiasis (Stones in Bile Duct)

All of the following sonographic appearances are found in cases of gallbladder carcinoma except:

What does the term hemobilia mean?

Term for inflammation of the bile ducts?

The valves of Heister are tiny valves found within the:

What is another word for fundus?

_______ is a clinical sign of gallbladder disease

_______________ is the connection from the gallbladder to the bile ducts.

Floating Gallstones

How thick should the gallbladder wall measure?

The bright linear echo within the liver connecting the neck of the GB and the right or main portal vein is called the:

Porcelain Gallbladder

What is represented by number 7?

Mirizzi Syndrome causes mechanical compression of the _______?

Gangrenous cholecystitis occurs after a prolonged infection, which causes the gallbladder to undergo ___________. 

A fusiform dilation of the common bile duct is known as:

Acute Cholecystitis

An elevation of ______ suggests obstruction of the ampulla of vater.

The physiologic effect of a fatty meal includes all of the following except:

Term for inflammation of the gallbladder?

Cholelithiasis (Gallstones)

Which one of the following is a function of the gallbladder?

What is the name of the fold in that gallbladder that occurs in the fundus?

A condition causing RUQ pain in which small polypoid masses arise from the GB wall demonstrating comet tail artifact is:

If a patient was positive for obstruction, how would the gallbladder appear?

The Murphy’s sign is an indication of _________?

The name of the fold in the neck of the gallbladder is called?

Caroli’s Disease

What is the sonographic appearance of Choledochal cyst?

Which of the following are sonographic appearances of GB carcinoma?

What part of the gallbladder is represented by number 2?

What is the appearance of the gallbladder if the patient is not NPO?

What is the more likely diagnosis for the patient below?

When the sonographer finds the presence of ductal dilation, what is the finding termed (the sign)?

Gallbladder Carcinoma

Are the following appearances (signs) associated with dilated intrahepatic ducts? Too many tubes & Stallate Confluence

How does the CBD change after removal of the Gallbladder?

Why does the Gallbladder appear round distended and non-flamed from Hydrops/Mucocele?

What are 3 symptoms of Cholangitis?

Emphysematous Cholecystitis (Intraluminal gas)

Cholangiocarcinoma (Tumors in Intrahepatic Ducts)

WES Sign “Wall Echo Shadow” (Also known as Double ARC)

Term for removal of the Gallbladder?

Mirizzi Syndrome (Extrahepatic biliary obstruction due to impacted stone in the cystic duct)

Patient presents with known history of GB infection. Patient has fever and chills and severe RUQ pain. Diagnosis?

There is expected change in the size of the CBD after the gallbladder is removed.

WHAT STRUCTURE IS THE ARROW POINTING TO?

Be able to recognize all the primary causes of Gallbladder wall thickening. Review #23 on Study Guide. Answer/ True

Term for “fatty” hormone that may be administered to cause the gallbladder to contract?

Gallbladder Sludge

What is represented by number 4?

Sclerosing Cholangitis (Dilated ducts with thickened walls)

Classic symptoms of gallbladder disease include all of the following except:

Murphy’s sign is a symptom of Cholecystitis.

What part of the abdomen hurts with Cholecystitis?

What is represented by number 6?

The following are 3 diagnostic criteria for _______? 1. Echogenic 2. Mobile 3. Shadowing

What is represented by number 5?

After the patient changes positions, what two area’s are checked to confirm no stones are lodged?

In what part of the world are Choledochal cyst prevalent?

80 - 90% of patient with Gallbladder Carcinoma will also have ________? (Hint- gallstones)

The Cystic Duct and _______ converge to form the common bile duct, which carries bile from the liver to the duodenum.

The Sphincter of Oddi “gate keeper” relaxes to allow bile/pancreatic enzymes to flow from ______ to the ______

The CBD should measure?

Which one of the following describes the most common sonographic appearance of gallbladder carcinoma?

The portal vein and hepatic artery flow which direction to the liver?

An obstruction in the distal portion of the CBD will result in dilation of ______ & _______?

Gas-forming bacteria in the gallbladder appear on ultrasound as a:

Term for gallstones?

Choledochal Cyst results in causing cystic dilation of the ____?

What Pathology is the term WES or Double Arc referring to?

What may be seen in the GB in patients w/ prolonged fasting or hyperalimentation therapy and with obstruction of the GB?

Bubbles that rise like champagne in a glass is a sign of ___________

What is represented by number 8?

What are the 5 F’s of gallbladder disease?

______ is another term used for Wall, Echo & Shadow sonographic appearance.

Select the appearances (Signs) associated with dilated Intrahepatic ducts.

Choledochal Cyst (Rare- weakness in the bile duct wall)

What is the mortality rate for untreated cholangitis?

The GB and _____ are dilated with Choledochal Cyst?

What is the mortality rate near for gallbladder carcinoma?

Serum Alkaline Phosphatase is a typical lab that is elevated with biliary obstruction.

Choledocolithiasis is the most common cause of _______ obstructive jaundice.

Empyema of the gallbladder involves purulent material (pus) due to _________?

The hepatic duct is joined by the ______________ to form the ________________.