Question

Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact Cholelithiasis, as well as potential associated alterations and symptoms. Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.

Answer 1

ANSWER

   * All of the above factors gender is one of the factor which promote

      the formation of cholelithiasis.

* Women are two to three time more likely to develop cholesterol stones.

* Increased risk in women is because of

                   * Use of oral contraceptives.(It contain estrogen which is a hormone

                      cause changes in the makeup of bile leads to gallstones or cholelithiasis).

                   * Estrogen replacement therapy in menopausal women.

                   * Obesity is more in women compared to men so they use clofibrate which

                      is a cholesterol lowering agent but in cause increase biliary cholesterol content

                      and leads to cholelithiasis.

* Associated alterations and symptoms.

                 * Epigastric distress folowing a meal rich in fatty foods.

                 * Biliary colic (upper abdominal pain radiating into back or right shoulder)

                 * Vomitting.

                 * Nausea.

                 * Palpable abdominal mass.

                 * Restlessness.

                 * Jaundice.

                 * Deficiencies of fat soluble vitamins (A,D,E and K).

                 * Clay coloured stool.

* Pathophysiology of associated alterations including intra and extra cellular changes.

          * In cholelithiasis progressive stages cystic duct is obstructed

             so the gall bladder become distended,inflamed and infection may occur.

      * Which result in fever,palpable abdominal mass,biliary colic,nausea and

              vomitting.

          * Digestion and absorption of fatty foods because altered due to bile obstruction

             caused by gall stones lead to epigastric distress after eating fatty foods.

          * Bile salts released by the liver give brown colour to stool but in case of gallstone

             it obstruct bile flow leads to clay coloured stool.

          * Obstruction of flow of bile impair digestion ans absorption of fat soluble vitamins

             ( A,D,E and K) result in vitamin deficiency diseases.

          * Gallstones obstruct the bile duct result in back up of bile into the liver and enter into

              blood stream leads to jaundice.

            * Cellular changes include

                       * Gall bladder epithelial cells show increased proliferation early.

                       * Formation of large number of degenerative cells in gall bladder.

                       * Increase mucus production in the epithelial cells of gall bladder.