Gallbladder Examination After Cholecystectomy Discussion

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Gallbladder Examination After Cholecystectomy Discussion

Part1

  1. The difference between primary and secondary types of Raynaud phenomenon.

Primary Raynaud’s phenomenon is characterized by vasospasms in reaction to cold temperatures or stress that have no underlying cause (Curtiss et al., 2022). Secondary Raynaud’s phenomenon, which is commonly caused by underlying illnesses such as lupus or scleroderma, has more severe symptoms and can cause tissue damage (Curtiss et al., 2022). The medical history of TB points to subsequent Raynaud’s disease caused by autoimmune diseases. Gallbladder Examination After Cholecystectomy Discussion

  1. The would be “chief complaint” in case of primary Raynaud phenomenon and Secondary Raynaud phenomenon.

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If TB had Raynaud’s phenomenon, her chief complaint would most likely be episodes of color changes in her fingers and toes caused by cold or stress, producing pain but no severe tissue damage. If she had secondary Raynaud’s phenomenon, her major complaint might be more severe and longer color changes, discomfort, and probable tissue ulcers as a result of underlying autoimmune disorders such as systemic lupus erythematosus and scleroderma worsening the vasospasms (Haque & Hughes, 2020).

  1. The expected assessment results based on TB’s presentation and in case she had primary Raynaud phenomenon?

Due to her systemic lupus erythematosus, TB’s presentation with secondary Raynaud’s phenomenon may indicate aberrant autoimmune markers, such as increased anti-nuclear antibodies (ANA) (Curtiss et al., 2022). Microvascular alterations may be revealed via nailfold capillaroscopy. If she had primary Raynaud’s phenomenon, the evaluation results would most likely indicate no particular autoimmune signs, with a focus on normal capillaroscopy findings and a milder clinical presentation caused mostly by cold or stress. Gallbladder Examination After Cholecystectomy Discussion

part 2

  1. Differentiate among the three types of cholecystitis.

Gallstones clogging the cystic duct cause acute inflammation and discomfort in acute calculous cholecystitis. Acalculous cholecystitis is inflammation without gallstones that occurs often in severely unwell individuals due to reduced gallbladder emptying. Chronic cholecystitis is characterized by chronic inflammation caused by recurring acute bouts or long-term irritation, and is frequently related with the presence of gallstones (Chen et al., 2022). The risk factors for MB point to acute calculous cholecystitis.

  1. Method for palpating the gallbladder.

During a physical examination, the gallbladder is often palpated using the “hooking” technique. The examiner stands on the right side of the patient and inserts their left hand beneath the patient’s right costal margin (Corten et al., 2020). The examiner reaches around the patient’s right side, just below the costal margin, with their right hand and asks the patient to take a deep breath. As the patient exhales, the examiner softly presses upward and inward with their fingertips, hoping to feel for any discomfort or enlargement of the gallbladder (Corten et al., 2020).

  1. The common symptoms of cholecystitis pain versus the associated symptoms.

A constant, strong pain in the right upper quadrant or epigastric area, typically extending to the back or right shoulder, is a common sign of cholecystitis discomfort (Chen et al., 2022). Nausea, vomiting, and bloating are possible side effects. Fever, chills, and jaundice may be associated symptoms, indicating an infection or blockage. Obesity, diabetes, and discomfort in the right upper quadrant in MB need a comprehensive investigation for cholecystitis and its consequences (Chen et al., 2022). Gallbladder Examination After Cholecystectomy Discussion

References

Chen, J., Gao, Q., Huang, X., & Wang, Y. (2022). Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute purulent cholecystitis. BMC gastroenterology, 22(1), 491.

Corten, B. J., Leclercq, W. K., van Zwam, P. H., Roumen, R. M., Dejong, C. H., & Slooter, G. D. (2020). Method for adequate macroscopic gallbladder examination after cholecystectomy. Acta Chirurgica Belgica, 120(6), 442-450.

Curtiss, P., Svigos, K., Schwager, Z., Sicco, K. L., & Franks Jr, A. G. (2022). Part I: Epidemiology, Pathophysiology, and Clinical Considerations of Primary and Secondary Raynaud’s Phenomenon. Journal of the American Academy of Dermatology. https://www.sciencedirect.com/science/article/abs/pii/S0190962222022502

Haque, A., & Hughes, M. (2020). Raynaud’s phenomenon. Clinical Medicine, 20(6), 580. 

Part1.

TB is a 56-year-old female patient with Raynaud phenomenon. Her past medical history includes spinal stenosis, systemic lupus erythematosus, bipolar disorder, and overactive bladder.

1. Differentiate the primary and secondary types of Raynaud phenomenon.

2. In the patient’s initial presentation what would be the chief complaint if the patient had primary Raynaud phenomenon? Secondary Raynaud phenomenon?

3. Based on TB’s presentation, what assessment results would you expect to find? What if is she had primary Raynaud phenomenon? Gallbladder Examination After Cholecystectomy Discussion

part 2
MB is a 44-year-old white female patient. She is obese, with a past medical history of hypertension, hyperlipidemia, and diabetes. She admits that she does not exercise. She is being evaluated today for right upper quadrant abdominal pain.

1. Differentiate among the three types of cholecystitis.

2. Describe the method for palpating the gallbladder.

3. Differentiate between the common symptoms of cholecystitis pain and the associated symptoms. Gallbladder Examination After Cholecystectomy Discussion