Block 3 - GB and pancreas Flashcards
Cholesterol stones are pale yellow and (radioluscent/radioopaque).
Increased with increased estrogen and Native Americans
Radioluscent
Bilirubin stones contain calcium salts and (conjugated/unconjugated) bilirubin
They are (radiolucent/radioopaque)
Caused by chronic hemolytic syndromes (increased plasma bilirubin) and infections
unconjugated
Radioopaque
Patient presents with steady or colicky upper abdominal pain, radiating to the right shoulder. Severe pain is elicited by pressing fingers under the right costal margin. The wall of the gallbladder appears edematous and thick, but not fibrotic.
acute cholecystitis
Repeated bouts of acute cholecystitis cause fibrosis of the gallbladder wall. Chronic inflammation is associated with Rokitansky-Aschoff sinuses and calcification.
>> Presence of mucosa deep in the muscle.
chronic cholecystitis
Extensive dystrophic calcification of the gallbladder with increased risk of cancer.
porcelain gallbladder
Malignant glands lined up with malignant pleomorphic cells seen infiltrating a densely fibrotic gallbladder wall
adenocarcinoma
•Failure of fusion of the dorsal and ventral pancreatic primordia fetal duct systems
Predisposes to chronic pancreatitis
pancreas divisum
- Bandlike ring of pancreatic tissue around the 2nd portion of the duodenum
- May present with duodenal obstruction
annular pancreas
Inappropriate intrapancreatic activation of trypsin, leading to activation of other enzymes, resulting in acinar cell injury (self-digestion). Acute pain, radiates to the back, from necrosis and inflammation, steatorrhea and glucose intolerance. Enzymes are seen in blood and urine. Hypocalcemia, hyperglycemia, jaundice.
Acute pancreatitis
Calcium combines with released fatty acids in areas of fat necrosis. Seen in acute pancreatitis.
saponification
Gene associated autosomal dominant chronic pancreatitis
PRESS1
gene associated with autosomal recessive chronic pancreatitis
SPINK1
Gene associated with chronic pancreatitis that also presents with pulmonary and other symptoms.
CFTR
Cystic space in the pancreas formed by a wall of fibrosis, filled with blood, fibroblasts, macrophages, and necrotic tissue. No true epithelial lining. Can be caused by acute or chronic pancreatitis or trauma. Elevated amylase and normal CEA.
pancreatic pseudocyst
____ cystic neoplasms:
usually multicystic neoplasms filled with clear fluid, arise twice as often in women as in men and typically present in the sixth to seventh decade of life. Benign
serous
____ cystic neoplasms: common in women, and, can be precursors to invasive carcinomas; usually presents as painless, slow-growing masses, filled with mucous; associated with KRAS oncogene and the P53 and SMAD4 tumor suppressor genes (Can show low or high-grade dysplasia)
mucinous
pancreatic neoplasm: in main duct, or branch ducts, more in men, precursor of invasive carcinoma (Can show low or high grade dysplasia)
