19 - Pancreas Pathology

Question 1

pancreas divisum

Answer 1

5-7% of population

failure of fusion of ducts of Wirsung and Santorini

Question 2

2 genetic causes of acute pancreatitis

Answer 2

cationic trypsinogen

SPINK1

Question 3

serous cystadenoma

Answer 3

pancreatic tumor, almost always benign, only remove if obstructing or something

Question 4

mucinous cystic neoplasm

Answer 4

bad news - highly assoc w/ invasive CA - resect

Question 5

intraductal papillary mucinous neoplasm

Answer 5

visible duct distended by mucin
most occur in head of pancreas
30% develop into invasive CA
excellent prognosis otherwise

Question 6

4 mutations assoc w/ pancreatic CA

Answer 6

kras
p16
SMAD4
p53

Question 7

MC part of pancreas to get CA

Answer 7

head

Question 8

signs/sx of pancreatic CA at head vs tail

Answer 8

head - bascially like obstructive pancreatitis

tail - insidious, wt loss, pain, trousseau sign, often not noticed until late

Question 9

the “good news” place to have peri-pancreatic CA

Answer 9

ampulla of vater - 50% overall five yr survival

Question 10

neuroendocrine tumors compared to adenoCA in pancreas

Answer 10

neuroendocrine is much nicer

Question 11

Whipple’s triad

Answer 11

characteristics of insulinoma

attacks of hypoglycemia (glucose < 50 mg/dl)
anxiety, cold sweat, confusion, loss of consciousness, stupor
precipitated by fasting or exercise, relieved by eating or IV glucose