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ABDOMEN REGISTRY > Chapter 5: Pancreas > Flashcards

Chapter 5: Pancreas Flashcards

1
Q

What is the uncinate process

A

The posteriomedial extension of the pancreatic head that some people have

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2
Q

What are the enzymes secreted by the exocrine portion of the pancreas

A

Amylase, lipase, sodium bicarbonate, trypsin, chymotripsin, and carboxypolypeptidase

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3
Q

What is the function of amylase

A

Digest carbohydrates and converts starch to sugar

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4
Q

What is the function of lipase

A

Digest fats and convert them to fatty acids and glycerol

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5
Q

What is the function of sodium bicarbonate

A

Neutralizes stomach acid

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6
Q

What is the function of trypsin, chymotripsin and carboxypolypeptidase

A

Breaks down proteins

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7
Q

_____ cells carry the exocrine function of the pancreas

A

Acinar

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8
Q

The enzymes travel through the main pancreatic duct which is also called ____

A

Duct of Wirsung

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9
Q

What is the duct of Santorini

A

Accessory duct that branches off of the main duct, it also has its own little sphincter

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10
Q

What is the name of the area where the sphincter of Oddi rests

A

Major duodenal papilla

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11
Q

What hormone causes relaxation and opening of the sphincter of Oddi

A

Cholecystokinin

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12
Q

What hormones are released by the endocrine portion of the pancreas

A

Alpha cells- Glucagon
Beta cells- Insulin
Delta cells- Somatostatin

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13
Q

What is the function of the alpha cells (glucagon)

A

Promotes the release of glucose by the liver (increasing blood sugar)

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14
Q

What is the function of beta cells (insulin)

A

Stimulates the body’s use of glucagon

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15
Q

What is the function of delta cells (somastotatin)

A

Restrains insulin and glucose level

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16
Q

The endocrine function is performed by the islets of _____

A

Langerhans

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17
Q

What vessel supplies blood to the head of the pancreas

A

Gastroduodenal artery

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18
Q

What vessels supply blood to the body and tail of the pancreas

A

Splenic artery and SMA

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19
Q

What four vessels drain the pancreas

A

Splenic vein
Superior mesenteric vein
Inferior mesenteric vein
portal vein

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20
Q

Normal echogenicity of the pancreas is greater than the liver and _____ to the spleen

A

Equal

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21
Q

The diameter of the main pancreatic duct should not exceed __ mm

A

2

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22
Q

The pancreas head and body should measure between ___ and ___ cm

A

2-3

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23
Q

The pancreas tail should measure ___ cm

A

1-2

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24
Q

What is pancreatic divisum

A

The most common congenital anomaly.
Shortened main pancreatic duct that drains only the head.

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25
Q

What happens to the duct of Santorini in a pancreatic divisum

A

It is forced to drain the rest of the pancreas

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26
Q

What complications does pancreatic divisum brings

A

Obstruction, improper pancreas drainage, high risk of developing inflammation ( prone to pancreatitis)

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27
Q

What is an annular pancreas

A

Cuando la parte de alante del páncreas se enrosca en el duodenum. May cause obstruction

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28
Q

What is acute pancreatitis

A

Inflammation of the pancreas secondary to leakage of pancreatic enzymes

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29
Q

What are the most common causes for acute pancreatitis

A

Alcohol abuse and biliary tract disease

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30
Q

What is phlegmon

A

Peripancreatic fluid collection

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31
Q

What is the most helpful lab value to diagnose pancreatitis

A

Lipase

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32
Q

Acute pancreatitis will cause a rise in amylase first, then a rise in _____

A

Lipase

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33
Q

Acute pancreatitis is divided into interstitial edematous pancreatitis or necrotizing pancreatitis. What is the difference

A

Interstitial edematous pancreatitis is better managed.
Necrotizing pancreatitis is fatal

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34
Q

What are the lab values elevated with acute pancreatitis

A

Amylase (within 24 hrs), Lipase (within 72 hrs), leukocytes, ALT

35
Q

What are the symptoms of acute pancreatitis

A

Abdominal pain (especially en supine)
Back pain, fever, nausea, vomiting. May lead to hemorrhage

36
Q

What does acute pancreatitis look like on ultrasound

A

Pancreas may appear normal or hypoechoic (when diffuse), focal hypoechoic area (when focal)
Fluid collection around
Pseudocyst
Abscess formation
Biliary obstruction
Splenic vein thrombosis and pseudoaneurysm of splenic artery (sometimes)

37
Q

What are the symptoms of chronic pancreatitis

A

Asymptomatic
Epigastric pain, jaundice, back pain, anorexia, vomiting, weight loss, constipation

38
Q

What lab values are elevated with chronic pancreatitis

A

Por roble elevation in ALP and amylase/lipase

39
Q

What does chronic pancreatitis look like on ultrasound

A

Heterogenous hyperechoic atrophic pancreas with poor margins and calcifications

40
Q

What other things can me present with chronic pancreatitis

A

Pancreatic pseudocyst
Dilated pancreatic duct (may have stones in it)
Portosplenic vein thrombosis

41
Q

What is the main cause of chronic pancreatitis

A

Alcohol abuse

42
Q

Pancreatic adenocarcinoma is also called pancreatic ____ adenocarcinoma

A

Ductal

43
Q

Pancreatic adenocarcinoma is most common in men or women

A

Men

44
Q

Pancreatic adenocarcinoma is most common in what part of the pancreas

A

Head

45
Q

Cancer of the pancreas had can eventually cause _____ obstruction and _______ gallbladder

A

CBD, Courvoisier

46
Q

What is the Whipple procedure

A

Pancreaticoduodenectomy

47
Q

During a pancreaticoduodenectomy, what is removed

A

Pancreas head, GB, prox duodenum, and bile ducts

48
Q

What are the symptoms of pancreatic adenocarcinoma

A

Loss of appetite, weight loss, jaundice, epigastric pain

49
Q

Pts with what type of history have a higher risk of developing pancreatic adenocarcinoma

A

Hx of smoking, diabetes, and chronic pancreatitis

50
Q

What lab values may be elevated with pancreatic adenocarcinoma

A

Amylase and/or lipase, ALP

51
Q

What does pancreatic adenocarcinoma look like on ultrasound

A

Hypoechoic mass on the head, double duct sign, Courvoiser gallbladder

52
Q

What does a Courvoiser gallbladder refer to

A

Large, palpable gallbladder

53
Q

A cystadenoma within the pancreas can be called a (microcystic) ______ cystadenoma, or a (macrocystic) ______ cystadenoma

A

Serous, mucinous

54
Q

Serous (microcystic) cystadenomas are small and ______

A

Benign

55
Q

Macrocystic (mucinous) cystadenomas are big and usually _______

A

Malignant

56
Q

When a mucinous tumor is malignant, it’s called

A

Mucinous cystadenocarcinomas

57
Q

Mucinous cystadenocarcinomas are often found in what part of the pancreas

A

Within the body and tail

58
Q

What are the symptoms of cystadenomas and cystadenocarcinomas

A

May be asymptomatic at first
Epigastric pain, weight loss palpable mass and jaundice

59
Q

What does a benign serous cystadenoma look like on ultrasound

A

Cystic small mass
May appear solid and echogenic due to how small it is

60
Q

What does a mucinous cystadenoma and cystadenocarcinoma look like

A

Multilocular cystic mass that may contain mural nodules and calcifications

61
Q

With mucinous cystadenomas and cystadenocarcinomas, there may be an associated dilation of the _____ duct

A

Pancreatic

62
Q

What is the gold standard imaging for the pancreas

A

Endoscopic retrograde cholangiopancreatography (ERCP)

63
Q

Islet cell tumors are also called pancreatic ______ tumors

A

Neuroendocrine

64
Q

What are islet cell tumors

A

Tumors found within islets of Langerhans

65
Q

There are two types of islet cell tumors: insulinoma and ______

A

Gastrinoma

66
Q

Insulinomas are more common and usually _____

A

Solitary

67
Q

Gastrinomas are usually how many

A

Múltiples

68
Q

Functional gastrinomas can cause _______ _______ syndrome

A

Zollinger Ellison

69
Q

What is Zollinger Ellison syndrome

A

Excessive secretion of acid by the stomach that leads to peptic ulcers

70
Q

Functional insulinomas can cause _____

A

Hypoglycemia

71
Q

What is the Whipple triad

A

A group of clinical indicators of a functional insulinoma

72
Q

What clinical indicators are included in the Whipple Triad

A

Hypoglycemia, low fasting glucose, and relieve with IV glucose administration

73
Q

What are some other symptoms of insulinomas

A

Palpitations, sweating, tremors, headaches, diabetic coma

74
Q

What does an islet cell tumor look like on ultrasound

A

Small hypoechoic mass that may contain calcifications
Hypervascularity may be present in the functioning tumors

75
Q

Cyst within the pancreas is associated with what three diseases

A

Von hippel-lindau disease (especially este)
Cystic fibrosis
Autosomal dominant polycystic kidney disease (ADPKD)

76
Q

When they do a pancreas transplant, ___% of the time they transplant the kidney too

A

80

77
Q

Describe exocrine bladder drainage pancreas transplant

A

Vasculature of donor is attached to pts iliacs
Donors duodenum is attached to bladder (used to expel pancreatic juices)

78
Q

Describe exocrine enteric drainage (more common)

A

Donors duodenum is attached to pt jejunum (where it expels pancreas juices)
Vasculature is connected to donors iliacs (Y graft)

79
Q

What does chronic transplant rejection look like

A

Hyperechoic, atrophy, calcifications

80
Q

What does acute transplant rejection looks like

A

Hypoechoic or heterogenous pancreas, elevated resistive indices

81
Q

What are some fluid collections that may occur with a transplant

A

Abscess
Ascites
Hematoma
Urinoma
Pseudocyst

82
Q

What index usually represents splenic vein thrombosis

A

> 1.0, with absent splenic inflow

83
Q

What are some pancreatic transplant vascular complications

A

Arterial stenosis, arterial thrombosis, graft thrombosis, pseudoaneurysm, splenic vein thrombosis, strictures

ABDOMEN REGISTRY (13 decks)

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