Clinical Topic 7: Intra-abdominal Cancer Flashcards
Where are most Pancreatic cancers located in the pancreas? Are they exocrine or endocrine? What type of cancer are they?
Most likely located in head and body, commonly exocrine and Adenocarcinoma
What are the 1) Tumour markers and 2) Genes associated with Pancreatic cancer?
1) CA19-9
2) BRCA2, PALB2
What is Grey Turner’s sign and Cullen’s sign? What do they suggest?
Grey Turner’s: Bruising in flank
Cullen’s Bruising in Umbillicus
Sign of Pancreatic Necrosis / Retroperitoneal Haemorrhage
What is Trousseau’s sign?
Migratory thrombophlebitis -> Palpable nodule under skin
Sign of Pancreatic (and lung, gastric) cancer
What is Courvieoser’s sign?
Palpably enlarged gallbladder which is nontender and accompanied with mild painless jaundice, the cause is unlikely to be gallstones.
What is the first-line imaging investigation for Pancreatic cancer?
EUS
What are the surgical options for patients with Pancreatic Cancer?
- Whipples procedure (Pancreatoduodenectomy)
- Pancreatectomy
- ERCP Stenting
What are the seven types of Neuroendocrine cells in the Pancreas and what hormones do they secrete? What are the respective PanNETs called (minus enterochromaffin cells)
Alpha cells - glucagon (glucagonoma) Beta cells - insulin (insulinoma) Delta cells - somatostatin (somatostatinoma) Gamma cells - PP (PPoma) G1 cells - gastrin (gastrinoma) D cells - VIP (VIPoma) Enterochromaffin cells - serotonin
What signs would an Insulinoma and a Glucagonoma cause?
Insulinoma - Hypoglycaemia
Glucagonoma - Hyperglycaemia (causing DM)
What signs would Gastrinomas cause?
Zollinger-Ellison syndrome
What signs would VIPomas cause?
WDHA: Watery diarrhoea, hypokalaemia, achlorhydria
What are the causes of Pancreatitis?
I - Idiopathic G - Gallstones E - Ethanol T - Trauma S - Steroids M - Malignancy / Mumps A - Autoimmune S - Scorpion sting H - Hypothermia, hypertriglycerideaemia, hypercalcaemia E - ERCP / Emboli D - Drugs i.e. AZT, NSAIDs, Enalapril, Valproic acid, Prava / Simvastatin
