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Robbins Pathology GI (Chptr 16,17,18,19) > Clinical- Pancreas Disorders > Flashcards

Clinical- Pancreas Disorders Flashcards

1
Q

While doing an EUS, what does large diffuse enlargement of the pancreas, peripheral rim of hypoattenuation, and irregular narrowing of the main pancreatic duct indicate

A

Autoimmune

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2
Q

While using EUS, what does hyperechoic foci with shadowing of the pancreas indicate

A

Calculi in the main pancreatic duct

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3
Q

Autoimmune pancreatitis is assocaited with which antibody

A

Hypergammaglobbulinemia (IgG4)

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4
Q

What are common complications of chronic pancreatitis

A 
Chronic abdominal pain
Brittle diabetes mellitus
Opioid/Narcotic addiction
Steatorrhea and malnutrition 
Pancreatic cancer
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5
Q

What finding on a CT in a patient with chronic pancreatitis becomes alarming

A

Tumefactive chronic pancreatitis is a sign for pancreatic cancer

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6
Q

What are the risk factors that will increase the risk for more serious pancreatitis with the high levels of fluid sequestration in the 3rd spacing

A 
Younger age
Alcohol
Higher hematocrit
Higher serum glucose
Systemic inflammatory response syndrome
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7
Q

Pancreatic cancers (especially neuroendocrine) are associated with which familiar cancer

A

MEN1

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8
Q

What is the colon cut off sign

A

Air in the transverse colon that abruptly ends around the location of the pancreatitis inflammation (causes a Splenic flexure spasm)

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9
Q

When should a contrast CT be avoided

A

When a patient does not have proper kidney function, as the creatinine will be >1.5

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10
Q

Which laboratory findings are consistent with an increased mortality due to SAP

A

Hypoalbuminemia and elevated serum lactic dehydrogenase (LDH)

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11
Q

What are the characteristics of a insulinoma

A

Associated with MEN1
Hypersecretion of insulin
High insulin and creative protein during hypoglycemia

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12
Q

What can be given if there is tetany due to the hypocacemia

A

Calcium gluconate

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13
Q

What are the cancers of the pancreas that are commonly associated with MEN1

A
  • Gastrinoma (ZE)

- Insulinoma

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14
Q

What are the clinical signs associated with pancreatic adenocarcinoma

A
  • Painless jaundice
  • pain, midepigastric that radiates to the pack, especially at night
  • Trousseau sign of malignancy
  • Courvoisier Sign (palpable gall bladder)
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15
Q

What is the process of saponification during acute pancreatitis

A
  • “Making into soap”

- Interaction of fatty acids (due to lipase) and calcium form a more solid structure, but also result in low calcium

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16
Q

What are the most common causes of acute pancreatitis

A

Cholelithiasis and alcohol

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17
Q

When can a secretin test be done for chronic pancreatitis

A

Sensitive test, where it becomes abnormal when >60% of pancreatic function is lost

18
Q

What is the result of acute pancreatitis on calcium levels

A

Decreased due to saponification

19
Q

What is the cardinal symptom in patients with chronic pancreatitis

A

Pain
Steatorrhea
Malabsorption

20
Q

What is the outcome during acute pancreatitis and the increases in BUN

A

The larger the increases in BUN, the higher the mortality

21
Q

What is the cause of steatorrhea in patients with CF or chronic pancreatitis

A

EPI or exocrine pancreas insufficiency

22
Q

What should be examined if they triglyceride levels are >1000

A

Check the lipid panel for Severe Acute pancreatitis

23
Q

What is the main cause of death in patients with chronic pancreatitis

A

Pancreatic cancer

24
Q

What is associated with a bad outcomes with regards to SIRS and elevated BUN

A

Presence of elevated BUN at admission with a rise in BUN 24 hours after, in addition to SIRS

25
Q

What are some non-pancreatic cases of increased amylase levels

A
  • High intestinal obstruction
  • Gastroenteritis
  • Mumps (salivary amylase)
  • Ectopic pregnancy
  • Opioids
  • Abdominal surgery
26
Q

What are the characteristics of gastrinoma in MEN1

A

Zollinger ellison syndome

  • nonbeta islet cell tumors, with the hypersecretion of gastrin
  • commonly found in the duodenum, then the pancreas
27
Q

What is chronic pancreatitis characterized by

A

Irreversible damage to the pancreas leading to:

  • Chronic pain and recurrent pancreatitis
  • pancreatic exocrine and endocrine insufficiency
28
Q

What is the most frequent cause of chronic pancreatitis

A

Alcoholism

29
Q

Which scans are useful in the case of an acute pancreatitis event

A

Plain X ray

Unenhanced CT

30
Q

What is given to patients with acute pancreatitis who are having the cases of persistent shock

A

Vasopressors

31
Q

What are the specific tests done for chronic pancreatitis

A

There is not one as lipase and amylase are normal

32
Q

What is the preferred method testing for acute pancreatitis

A

Increased lipase (more accurate than amylase)

33
Q

What is the most important treatment of acute pancreatitis

A

Safe, aggressive IV fluid resuscitation

34
Q

What imaging can be done for chronic pancreatitis

A

Plain films to look for pancreatic calcification

35
Q

What is the cause of seminal loop sign

A

Air in the small intestine in the left upper quadrant

36
Q

What are the fecal tests that can be done for patients suspected of pancreatic insufficiency

A

Fecal elastase 1 and a small bowel biopsy

37
Q

What are the criteria to be labeled as acute pancreatitis or severe acute pancreatitis

A

2 of the 3:

  • Abdominal pain in the epigastric area that radiates to back
  • threefold election in the serum lipase or amylase
  • Conformational findings of AP on cross section align abdominal imaging
38
Q

What is the relation between ARDS and acute pancreatitis

A

In severe cases, acute pancreatitis can lead to cases of acute respiratory distress, usually 3-7 days later
-those who required large crystalloid volumes and colloid volumes t maintain BP

39
Q

What is the description of pain during acute pancreatitis

A

Boring pain in the epigastric and periumbilical region that may radiate to the back

40
Q

Why should careful consideration be taken in performing an ERCP during a pancreatitis

A

A complication of ERCP is pancreatitis

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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