20: Pancreas Flashcards
Is the pancreas retroperitoneal?
Yes
What embryo portion of the pancreas is the head derived from?
Both dorsal and ventral
Which takes up more of the pancreas, exocrine or endocrine part
Exocrine
Three protective mechanisms so the pancreas isn’t digested by its own enzymes
- Enzymes secreted as zymogens
- Zymogens need to be actived by trypsin, which needs to be activated by enterokinase in the SI
- Acinar and ductal cells secrete trypsin inhibitors (SPINK1)
What causes Cullens and Grey-Turner sign in acute pancreatitis
Liberated pancreatic enzymes -> diffusion of fat necrosis and inflammation
Cardinal manifestation of acute pancreatitis
Abdominal pain
5 Histologic findings in acute pancreatitis
- Micro vascular leads -> edema
- Fat necrosis
- Acute inflammation
- Damage and autodigestion of parenchyma
- Blood vessel destruction -> hemorrhage
What can occur with systemic lipase release during acute pancreatitis?
Fat necrosis in omentum and mesentery
In 40-60% of acute necrotizing pancreatitis, what happens?
Acellular debris becomes infected with gram (-) organisms from the gut
Most common cause of chronic pancreatitis
Long term alcohol use
Major cytokine involved in chronic pancreatitis and what it’s released from
TGF-B from macrophages
Two diseases associated with congenital cysts of the pancreas
- AD poly cystic kidney disease
2. Von Hippel-Lindau disease
what does PanIN stand for
Pancreatic intraepithelial neoplasia
Areas where pancreatic cancer might metastasize
Spleen, adrenals, colon, stomach, LNs around those areas, large vessels, liver and lungs
Pathology of Trousseau sign of malignancy
Coagulation factors and inflammatory mediators are released from tumor cells -> migratory clots
