Acing boards panc/bili Flashcards
FAMMM Genetics and presentation
Familial atypical multiple mole melanoma, autosomal dominant mutations in CDKN2A on chromosome 9. These patients have multiple nevi, pancreatic cancer in family, and melanoma
Autosomal dominant hereditary pancreatitis genetics? What causes the pancreatitis?
PRSS-1, excessive trypsin 1. These patients have a higher risk of pancreatic cancer especially if they smoke
Autosomal recessive hereditary pancreatitis genetics
SPINK-1
Side effect of high doses of pancreatic enzymes?
Fibrosing colonopathy – colon stricture
Cause of recurrent pancreatitis, diarrhea, iron deficiency anemia?
Celiac disease – can happen from papillary stenosis from duodenal inflammation
How to manage ampullary adenoma?
Surveillance if asymptomatic and small.
Endoscopic ampullectomy if less than 2-3cm and no spread.
If bigger, then Whipple or surgical ampullectomy
When to do sphincter of Oddi manometry? What is considered abnormal?
With suspected biliary pain without dilation. With dilation can just proceed directly to sphincterotomy.
Normal is resting tone <40mmhg.
Role of ERCP with pancreas divisum?
Only when symptomatic with recurrent pancreatitis (do ERCP and minor papillotomy).
Do not need ERCP with incidentally detected pans divisum.
What condition comes with acute abdominal pain, pallor, sudden expansion of pancreatic pseudocyst?
Ruptured pseudoaneurysm, call IR or surgery
How to treat bleeding from esophageal varices in the setting of splenic vein thrombosis?
Splenectomy
Common pancreas tumor in NF?
Somatostatinoma – causes diarrhea and diabetes
MEN 1 Syndrome
Pituitary adenoma, parathyroid issue, pancreas tumor (insulinoma)
Kasabach-Merritt Syndrome and treatment to stop complications
Large liver hemangioma and DIC. Treat by removing the hemangioma
Fitz-Hugh Curtis Syndrome. How to diagnose?
Violin string capsular liver adhesions due to gonococcal salpingitis. Needs pelvic exam
