CH 8- Panc

Question 1

The pancreas is a ______ structure. It functions as an _____ & _____ gland

Answer 1

1) retroperitoneal

2) endocine

3) exocirine

Question 2

Its endocrine function is to ______ via the ______.

Answer 2

1) secrete insulin

2) islets of Langerhans

Question 3

Its exocrine function is to secrete _____, ____, & _____.

Answer 3

1) Trypsin

2) Lipase

3) Amylase

Question 4

The pancreas lies between the ______ & the ______.

Answer 4

1) Splenic hilum

2) Duodenal loop

Question 4

The GDA is ______ to the pancreatic head & the CBD is _____ to the pancreatic head.

Answer 4

1)anterolateral

2) posterolateral

Question 5

The SMA/SMV are ______ to the neck of the pancreas & _____ to the uncinate process.

Answer 5

1) posterior

2) anterior

Question 5

The splenic artery courses along the ____ boarder of the pancreas & the splenic vein is ______.

Answer 5

1) Superior

2) posterior

Question 5

The main pancreatic duct, the ______, courses through the pancreas & joins the CBD to form the _______.

Answer 5

1) the duct of Wirsung

2)ampulla of Vater

Question 5

The ampulla of Vater empties into the __________

Answer 5

second portions of the duodenum

Question 6

The accessory pancreatic duct, the ______, empties into the _____, ______ to the ampulla of Vater.

Answer 6

1) the duct of Santorini

2) duodenum

3) proximal

Question 7

A pancreas divisum occurs when the ventral & dorsal pancreatic buds _________ & each maintains a ______.

Answer 7

1) do not fuse

2) separate duct

Question 8

Pancreas Divisum results in a a smaller ______ which may cause _____ due to inadequate pancreatic enzyme drainage. There are many ______.

Answer 8

1) Ducts of Santorini

2) Pancreatitis

3) Variations

Question 9

True pancreatic cyst are ______. They are associates with _______, ______, & _______.

Answer 9

1) rare

2) ADPKD

3) von Hippel- Limdau

4) Cystic Fibrosis

Question 10

Congenital cyst (true cyst) of the pancreas are caused by ____________________.

Answer 10

anomalous development of the pancreatic ducts.

Question 11

Pancreatic cyst may also occur in the following (6)

Answer 11

1) Pancreatitis
2) ADPKD
3) Cyst adenoma/adnocarcinoma
4) Cystic lymphangioma
5) Hydatid disease
6) Pancreaticoblastoma

Question 12

In an Annular Pancreas, the ventral segment of the developing pancreas ______ & forms a ring of ________ around the __________.

Answer 12

1) encircles the duodenum

2) pancreatic tissue

3) duodenum

Question 13

Annular Pancreas causes_______.
( _____ most common congenital pancreatic anomaly)

Answer 13

1) obstruction of the gastric outlet

2) 2nd most common

Question 14

An Annular Pancreas occurs with other congenital disorders

Answer 14

1) Down’s syndrome
2) TEF
3) intestinal atresia
4) pancreas divisum

Question 15

Annular Pancreas is more common in ______.

Answer 15

Males

Question 16

An Ectopic Pancreas lies in the _____ position & occurs around the _____ of the _____ or the _______.

Answer 16

1) submucosal

2) atrium of the stomach

3) proximal small bowel

Question 17

An Ectopic Pancreas is associated with _______, _______ & ________.

Answer 17

1) VATER syndrome

2) gut malrotation

30 duodenal atresia

Question 18

Nesidioblastosis is is _____ of the fetal state of the pancreas. They secrete _______. Babies present with ______.

Answer 18

1) persistance

2) insulin

3) hypoglycemia

Question 19

pg 176

Question 19

_____ % of children with cystic fibrosis have pancreatic insufficiency, which leads to _____ & ______.

Answer 19

1) 85%

2) stetorrhea ( fat in feces)

3) malabsorption

Question 20

Thickened mucous lines the ____, ___ & ____

Answer 20

1) pancreatic

2) bronchial

3) biliary ducts

Question 21

The ____ & ____ in the pancreas become dilated due to the mucous & cause ______ & _____

Answer 21

10 ducts

2) acini

3) small cyst

4) fibrosis

Question 22

The obstruction & distention lead to _____, ____, ____, ____ & ____ in the pancreas

Answer 22

1) degeneration

2) atrophy

3) insufficiency

4) fibrosis

5) fatty replacement

Question 23

Sonographically with panc. abn. you see an ____ in the echogenicity & a ____ in pancreatic size.

Answer 23

1) increase

2) decrease in size

Question 24

Shwachmann syndrome causes ____- & ____ of the pancreas.

Answer 24

1) pancreatic insufficiency

2) fatty infiltration

Question 25

_______ is the most common cause of pancreatic insufficiency after cystic fibrosis. Sonographically, you see a _______ pancreas

Answer 25

1) Shwachmann syndrome

2) normal hyperechoic panc

Question 26

Scwachman syndrome includes (4)

Answer 26

1) metaphyseal chondroplasia (shortening of the est)

2) metapyseal widening

3) “ cupping” of the ribs

4) bone marrow hypopasia

Question 27

Acute pancreatitis in children is usually due to ______ or ______. It can also be caused by ___, ____ & _________.

Answer 27

1) blunt abdominal trauma

2) non accidental injury (child abuse) * most common in children

3) mumps

4)drug toxicity

5) biliary & pancreatic anomalies

Question 28

with acute pancreatitis, pseudocyst form & may get ____ or ____ . Sonographically the pancreas appears ___ & ____.

Answer 28

1) infected

2) hemorrhage

3) hyperechoic

4) edematous

Question 29

pancreatitis symptoms consist of constant _____ or ____ pain which ________ and the patient has markedly raised ______. _____ & _____ must be stopped

Answer 29

1) severe epigastric pain or

2) periumbilical pain

3) radiates to the back & shoulders

4) amylase levels

5) Rest & oral feedings

Question 30

Chronic pancreatitis is due to ____ & is _____. Patients present with ____ & lose _____.

Answer 30

1) repeated attacks

2) not reversible

3) abd pain

4) pancreatic function

Question 31

With chronic pancreatitis the panc is usually small due to _____ & appears ____. ___ may be present & dilation of the ____ is common.

Answer 31

1) fibrosis

2) heterogenous

3) calcifications

4) CBD

Question 32

Causes of chronic pancreatitis in children include (5)

Answer 32

1) autoimmune pancreatitis

2) hereditary pancreatitis

3) Cystic Fibrosis

4) pancreas divisum

5) abdominal trauma

Question 33

Complications may occur to surrounding vessels of the pancreas due to ______. _______ can erode the vessels or cause thrombosis, hemorrhage,, rupture, or a pseudoaneurysm

Answer 33

1) their proximity

2) pancreatic enzymes

Question 34

Bowel perforation may result due to _____ by the _____. _____ may also occur due to vascular complications.

Answer 34

1) erosion

2) pancreatic enzymes

3) Ischemia

Question 35

Pancreatic neoplasms are _____ in children. They may be ___ or____.

Answer 35

1) extremely rare

2) cystic

3) solid

Question 36

Pancreatic Serous Cystadenomas are a _____ neoplasms that arise from ____ of the pancreas . Numerous ____ with ____ & ___ are seen

Answer 36

1) Benign

2) acinar cells

3) small cyst

4) protienaceous fluid

5)Septa

Question 37

Large cystadenomas may cause _____ or ____ & may require _____. They are more commonly seen in the ___ & ___ of the pancreas. They area associated with ________

Answer 37

1) CBD obstruction

2) pancreatic atrophy

3) head & neck

4) von Hippel-Lindau disease

Question 38

Pancreatic Mucinous Cystadenomas are considered _____ & largely occur in the ___ & ___ of the panc.

Answer 38

1) permalignant/malignant

2) body

3)tail

Question 39

Pancreatic Mucinous Cystadenomas hava a distinctive _______ & are more common in ____

Answer 39

1) ovarian-type stroma ( a type of supportive tissue)

2) females

Question 40

Pancreatic pseudocyst area collection of ___ & ___ encapsulated by _____.

Answer 40

1) panc fluid

2) inflammatory exudates

3) fibrous tissue

Question 41

Pancreatic pseudocyst develop ___ or are due to ___ of the panc. Most psudocyst are located in the ___ & ___

Answer 41

1) post trauma

2) inflammatory injury

3) Body & tail

Question 42

Pancreatic pseudocyst may be complicatied due to ___ or ___.
____, ____, & ____ levels are seen sonographically

Answer 42

1) hemorrhage or infection

2) septations

3) internal echoes

4) fluid filled debris

Question 43

Solid pancreatic neoplasms are predominately _____. They include _____ (benign) & _____ (malignant)

Answer 43

1) endocrine

2) Insulinomas (benign)

3) Gastronomas (malignant)

Question 44

______ are the most common malignant neoplasm & similar findings as those seen in adults are seen, although they are ____ in pediatric patients

Answer 44

1) Adenocarcinomas

2) rare in peds

Question 45

A ________ is a rare solid pancreatic tumor & is associated with ______ syndrome.

Answer 45

1) Pancreaticoblastoma

2) Beckwith-Weidemann Syndrome