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Biliary disorders

Description

Quiz to prep for Biliary Disorders lecture.
Ash Lig
Quiz by Ash Lig, updated more than 1 year ago
Ash Lig
Created by Ash Lig over 9 years ago
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Resource summary

Question 1

Question
How much bile does the gallbladder usually store?
Answer
  • 60-100 mL
  • 30-60 mL
  • 20-50 mL
  • 5-10 mL

Question 2

Question
Bile leaves the ____ via the ____ duct and enters the _____ via the _____ duct.
Answer
  • liver; hepatic; gallbladder; cystic
  • gallbladder; cystic; liver; hepatic
  • liver; anterior; gallbladder; cystic
  • liver; common; gallbladder; receiving

Question 3

Question
The two main functions of the gallbladder are to (store/produce) bile and to (concentrate/dilute) bile.
Answer
  • store; concentrate
  • produce; dilute
  • store; dilute
  • produce; concentrate

Question 4

Question
Fat enters the ________, which causes intestinal mucosa to secrete _________. This stimulates gallbladder contraction.
Answer
  • duodenum; cholecystokinin (CCK)
  • duodenum; motilin
  • stomach; cholecystokinin (CCK)
  • stomach; motilin

Question 5

Question
Cholinergic braches of the _____ nerve mediate gallbladder contraction.
Answer
  • Vagus
  • Lumbar
  • Thoracic
  • Phrenic

Question 6

Question
How much bile does the liver secrete each day on average?
Answer
  • 700-1200 mL
  • 100-200 mL
  • 800-1000 mL
  • 1000-1500 mL

Question 7

Question
Bile is an _______ substance.
Answer
  • Alkaline
  • Acidic

Question 8

Question
What is the function of bile salts?
Answer
  • To produce primary bile acids
  • To emulsify and absorb fats
  • To produce secondary bile acids
  • To stimulate contraction of the gallbladder

Question 9

Question
Why are gallstones harmful?
Answer
  • They release toxins into the gallbladder, which impairs the digestive system
  • They can be ejected from the gallbladder and become lodged in the cystic duct or anywhere in the biliary tree and obstruct the flow of bile
  • They can travel into the stomach and disrupt the acidic environment needed to absorb fat-soluble vitamins
  • They cause an inflammatory response in the gallbladder, which triggers the liver to abruptly stop it's production of bile

Question 10

Question
Cholelithiasis can cause the formation of gallstones.
Answer
  • True
  • False

Question 11

Question
Where might gallstones be found? Select all that apply.
Answer
  • Hepatic duct
  • Gallbladder
  • Cystic duct
  • Common bile duct

Question 12

Question
What does it mean if a patient is diagnosed with choledocholithiasis?
Answer
  • They have gallstones lodged in the common bile duct
  • They have gallstones lodged in the hepatic duct
  • They have gallstones present in the body of the gallbladder
  • They are in what is known as a "Lithogenic" state, in which conditions favor gallstone formation

Question 13

Question
Which type of gallstone is most common?
Answer
  • Cholesterol gallstones
  • Black pigmented gallstones
  • Brown pigmented gallstones
  • Mixed stones

Question 14

Question
Which of the following can decrease your risk of forming gallstones?
Answer
  • Nuts
  • Unsaturated fat
  • Insoluble fiber
  • Saturated fat
  • Refined carbohydrates

Question 15

Question
60-80% of people with cholelithiasis are asymptomatic.
Answer
  • True
  • False

Question 16

Question
From the following list, select the two cardinal manifestations of cholelithiasis.
Answer
  • Epigastric and right upper quadrant pain
  • Intolerance to fatty foods
  • Jaundice
  • Flatulence
  • Nausea and vomiting
  • Heartburn

Question 17

Question
Ultrasound detects gallstones in 95% of cases.
Answer
  • True
  • False

Question 18

Question
Which form of diagnostic imaging is most useful in detecting gallstones in the common bile duct?
Answer
  • Ultrasound
  • Gallbladder nuclear scanning (cholescintigram)
  • Endoscopic retrograde cholangio-pancreatography (ERCP)
  • Magnetic resonance cholangio-pancreatography (MRCP)

Question 19

Question
A combination of surgical and non-surgical treatments are recommended for both asymptomatic and symptomatic patients with gallstones.
Answer
  • True
  • False

Question 20

Question
From the following, select all correct contraindications for a laproscopic cholecystectomy.
Answer
  • stones are in the CBD
  • stones are in the gallbladder
  • client's physique does not allow access to the gallbladder
  • stones are primarily pigmented, not cholesterol

Question 21

Question
Patients with acute cholecystitis often present with nausea and vomiting. What is responsible for this manifestation?
Answer
  • Impulse transmitted to vomiting center from distention of bile duct
  • Impulse transmitted to vomiting center from distention of the gallbladder
  • Impulse transmitted to vomiting center from inflammation of gallbladder walls
  • Build up of toxins, secondary to necrosis of parenchymal tissue

Question 22

Question
A patient presents to the ER with acute pain in the supscapular region that started suddenly. The patient is also complaining of nausea, vomiting, and has a low grade fever. You suspect this patient has acute cholecystitis. Which diagnostic study will likely be done first?
Answer
  • Biliary ultrasound
  • Abdominal xray
  • MRI
  • ERCP

Question 23

Question
4-8% of patients with acute cholecystitis are acalculous (no stones). From the following, select all common causes of the acute inflammation.
Answer
  • Severe burns
  • Multiple transfusions
  • Bacterial sepsis
  • Prolonged childbirth (postpartum period)
  • Debilitating systemic diseases (e.g. TB, CVD)

Question 24

Question
50% of cases of acute acalculous cholecystitis have no apparent precipitating factors.
Answer
  • True
  • False

Question 25

Question
Chronic cholecystitis is almost always associated with gallstones (95% of cases). Which of the following populations has the highest incidence of this condition?
Answer
  • Middle-aged and older obese women
  • Older obese men
  • Older men and women with poorly managed diabetes
  • Obese children

Question 26

Question
Which of the following statements is INCORRECT regarding gallbladder function?
Answer
  • Within 30 minutes of eating, the gallbladder forces bile into the stomach.
  • Cholinergic branches of the vagus nerve mediate gallbladder contraction.
  • Cholecystokinin and motilin provide hormonal regulation of gallbladder contraction.
  • The sphincter of Oddi controls the flow of bile from the gallbladder.

Question 27

Question
A patient was admitted to the hospital with a diagnosis of acute cholecystitis due to cholethiasis. The client complains of severe abdominal pain, nausea, and has vomited 3 times. What is the priority nursing diagnosis for this client?
Answer
  • Imbalanced nutrition: less than body requirements related to vomiting
  • Deficient fluid volume related to vomiting
  • Infection related to gallbladder inflammation
  • Acute pain related to biliary spasm

Question 28

Question
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
Answer
  • yellow sclerae
  • light amber urine
  • circumoral pallor
  • black, tarry stools

Question 29

Question
Which of the following descriptions best describes Murphy's sign?
Answer
  • Periumbilical eccymosis exists
  • On deep palpation and release, pain is elicited
  • On deep inspiration, pain is elicited and breathing stops
  • Abdominal muscles are tightened in anticipation of palpation

Question 30

Question
Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?
Answer
  • Administration of antibiotics
  • Assessment for complications (e.g. infection, n/v, sepsis)
  • Health teaching
  • Preparation for surgery
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