gallbladder flashcards

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standalone flashcards

term included in every answer

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🧠 GALLBLADDER PATHOLOGY – DETAILED FLASHCARDS

🟢 BASIC OVERVIEW

Q: What is the function of the gallbladder?

A: The gallbladder stores and releases bile to aid in fat digestion

🚨 CLINICAL SYMPTOMS

Q: What type of pain is associated with gallbladder disease?

A: Gallbladder disease commonly presents with right upper quadrant (RUQ) pain, which may radiate to the right shoulder or right flank

Q: What is postprandial pain in gallbladder disease?

A: Postprandial pain occurs after eating (especially fatty meals) because fat intake stimulates gallbladder contraction, which can worsen obstruction and cause pain

Q: What is Murphy’s sign?

A: Murphy’s sign is pain with deep inspiration while pressing on the RUQ, indicating acute cholecystitis

Q: What is the sonographic Murphy’s sign?

A: The sonographic Murphy’s sign is maximal pain when the ultrasound probe presses over the gallbladder, with >95% accuracy for acute cholecystitis

Q: What causes jaundice in gallbladder disease?

A: Jaundice occurs due to biliary obstruction leading to increased bilirubin levels

🧪 SONOGRAPHIC FINDINGS

Q: What are general ultrasound findings in gallbladder disease?

A: Findings include wall thickening (>3 mm), pericholecystic fluid, duct dilation, and a positive Murphy’s sign

Q: What defines gallbladder wall thickening?

A: Gallbladder wall thickening is defined as a wall measuring >3 mm (measured at the anterior wall only)

Q: What causes gallbladder wall thickening?

A: Causes include:

  • Intrinsic: cholecystitis, carcinoma

  • Extrinsic: ascites, CHF

Q: What is pericholecystic fluid?

A: Pericholecystic fluid is fluid surrounding the gallbladder, indicating inflammation or possible perforation

Q: How do you confirm bile ducts vs vessels on ultrasound?

A: Use Color Doppler, where bile ducts show NO flow and vessels show flow

🪨 CHOLELITHIASIS

Q: What is cholelithiasis?

A: Cholelithiasis is the presence of gallstones within the gallbladder

Q: What are key facts about cholelithiasis?

A: Cholelithiasis is the most common gallbladder disease, more common in women, and most stones are cholesterol stones

Q: What are classic ultrasound findings of gallstones?

A: Gallstones appear as:

  • Echogenic

  • Mobile

  • Posterior acoustic shadowing

  • May show twinkle artifact on Doppler

Q: What are variations of gallstones?

A: Variations include large stones, gravel (tiny stones), and stones mixed with sludge

PITFALLS

Q: What can cause false positives for gallstones?

A: False positives include bowel gas, ligamentum teres, and folds (valves of Heister)

Q: What can cause false negatives for gallstones?

A: False negatives include incorrect settings or stones hidden in the neck (Hartmann pouch) or fundus (Phrygian cap)

WES SIGN

Q: What is the WES sign?

A: The WES sign (Wall-Echo-Shadow) indicates a contracted gallbladder filled with stones, showing only the anterior wall with shadowing behind it

👉 Also called the double arc shadow sign

🟤 GALLBLADDER SLUDGE

Q: What is gallbladder sludge?

A: Gallbladder sludge is thick bile composed of calcium, mucus, and cholesterol

Q: What are ultrasound findings of sludge?

A: Sludge appears:

  • Echogenic

  • NO shadow

  • Moves slowly

  • Layers in the dependent portion

Q: How do you differentiate sludge from stones?

A:

  • Stone = posterior shadowing

  • Sludge = NO shadow

🔸 SPECIAL SLUDGE TYPES

Q: What is tumefactive sludge?

A: Tumefactive sludge appears mass-like but has no vascular flow and moves slowly, helping differentiate from tumors

Q: What are sludge balls?

A: Sludge balls are round, mobile echogenic structures without shadowing, which can mimic stones

Q: What is hepatization of the gallbladder?

A: Hepatization occurs when the gallbladder is filled with sludge and appears similar in echogenicity to liver tissue

🔥 ACUTE CHOLECYSTITIS

Q: What is acute cholecystitis?

A: Acute cholecystitis is inflammation of the gallbladder, 95% caused by gallstones

Q: What are ultrasound findings of acute cholecystitis?

A: Findings include:

  • Gallstones

  • Wall thickening (>3 mm)

  • Pericholecystic fluid

  • Positive Murphy’s sign

  • Hyperemia on Doppler

Q: What is the treatment for acute cholecystitis?

A: Treatment includes cholecystectomy, or antibiotics/drainage if unstable

COMPLICATIONS

Q: What is empyema (suppurative cholecystitis)?

A: Empyema of the gallbladder is the presence of pus within the gallbladder, associated with fever and chills

Q: What is emphysematous cholecystitis?

A: Emphysematous cholecystitis is infection with gas-forming organisms (e.g., E. coli), showing gas with dirty shadowing, and has high mortality

Q: What is gangrenous cholecystitis?

A: Gangrenous cholecystitis is ischemia leading to necrosis of the gallbladder wall, increasing risk of perforation

🔁 CHRONIC CHOLECYSTITIS

Q: What causes chronic cholecystitis?

A: Chronic cholecystitis is caused by repeated inflammation due to intermittent obstruction by stones

Q: What are symptoms of chronic cholecystitis?

A: Symptoms include fat intolerance, RUQ pain, nausea/vomiting, and recurrent attacks

Q: What conditions can mimic chronic cholecystitis?

A: Mimics include adenomyomatosis and gallbladder carcinoma

OTHER CONDITIONS

Q: What is acalculous cholecystitis?

A: Acalculous cholecystitis is inflammation of the gallbladder without stones, often seen in ICU patients due to ischemia or bile stasis

Q: What is a hydropic gallbladder?

A: A hydropic gallbladder is an enlarged gallbladder (>4 cm AP) due to obstruction

Q: What is a porcelain gallbladder?

A: A porcelain gallbladder is a calcified gallbladder wall, associated with increased cancer risk

Q: What is Courvoisier gallbladder?

A: Courvoisier gallbladder is an enlarged, painless gallbladder associated with pancreatic cancer and painless jaundice

🍔 BOUVERET SYNDROME

Q: What is Bouveret syndrome?

A: Bouveret syndrome is gastric outlet obstruction caused by a gallstone passing through a fistula into the GI tract

🌿 HYPERPLASTIC CONDITIONS

Q: What is adenomyomatosis?

A: Adenomyomatosis is gallbladder wall thickening with Rokitansky-Aschoff sinuses, producing a comet tail artifact (key sign)

Q: What is cholesterolosis?

A: Cholesterolosis is fat deposition in the gallbladder wall, giving a “strawberry gallbladder” appearance, with NO comet tail artifact

🌱 GALLBLADDER POLYPS

Q: What are ultrasound features of gallbladder polyps?

A: Gallbladder polyps are:

  • Non-mobile

  • Echogenic

  • No shadowing

  • May have a vascular stalk

Q: What size of gallbladder polyp is concerning?

A: Polyps ≥10 mm raise concern for malignancy

🎗 GALLBLADDER CARCINOMA

Q: What is gallbladder carcinoma?

A: Gallbladder carcinoma is a rare but aggressive malignancy associated with gallstones, porcelain gallbladder, and large polyps

Q: What are ultrasound findings of gallbladder carcinoma?

A: Findings include:

  • Non-mobile mass

  • Irregular wall thickening

  • Internal vascularity

🔥 FINAL COUNT

👉 This set = ~52–55 flashcards (very similar to your biliary set)

If you want next step:

🔥 I can combine BOTH sets into:

  • 100-card master ARDMS deck

  • OR make “trap-style exam questions” (this is what actually boosts your score fast)