Disorders

Question 1

Describe Islet Endocrine cell tumours of the pancreas?

Answer 1

Neoplastic proliferation of endocrine cells of the islets.
May produce hormones - insulin, glucagon and somatostatin.
Patients present with symptoms due to excessive hormone.

Question 2

Describe Pancreatits?

Answer 2

Inflammation of pancreas.

Acute: Serious, life-threatening and sudden onset. Damage to the tissue releases dangerous digestive enzymes directly into surroundings.

Chronic: May follow repeated acute damage. Scarring and loss of normal tissue. Malabsorption and risk of secondary diabetes due to loss of function.

Question 3

Describe pancreatic carcinomas?

Answer 3

Malignant tumour of the pancreas. Poor prognosis.
Usually in head of pancreas - so presents with obstructive jaundice by blocking common bile duct.
May invade into adjacent structures such as stomach, duodenum, transverse colon and major vessels.
Can spread to nodes, liver and peritoneal cavity.

Body or tail usually has few symptoms so often diagnoses late and present with metastases.

Question 4

Describe adrenal adenoma?

Answer 4

Benign tumour of the adrenal cortex. 
May produce excessive hormones as cells are similar to normal;
- Cortisol (Cushings syndrome)
Aldosterone (Conns syndrome) 
- Adrenal androgens. 

Patients may present with symptoms due to hormonal affects or may come across it in imaging by coincidence.

Question 5

Describe adrenal cortical carcinoma?

Answer 5

Malignant proliferation of cells of adrenal cortex.
Cells dont look like normal and are less differentiated.
May invade into surrounding structures or metastasise.

Question 6

Describe adrenal atrophy?

Answer 6

Decrease in functional mass of cortex.
Often iatrogenis - after corticosteroid use long term. Negative feedback blocks ACTH production and no stimullus for cortical cells.
Sometimes due to autoimmune destruction (addisons disease).

Question 7

Describe Phaechromocytoma?

Answer 7

Uncommon tumour of adrenal medulla.
Can cause high levels of adrenaline and noradrenaline (may cause secondary hypertension).
Metabolites can be detected in urine for diagnosis.