Disorders of the Pancreas

Question 0

Test to differentiate macroamylasemia from acute pancreatitis

Answer 0

Serum protein electrophoresis

Question 1

Enzyme measured in acute pancreatitis that tends to rise sooner

Answer 1

Lipase

Question 2

A rare cause of benign elevations in the amylase and/or lipase levels, also known as benign pancreatic hyperenzymemia

Answer 2

Gullo syndrome

Question 3

Best imaging test to diagnose acute pancreatitis

Answer 3

Contrast-enhanced CT

Question 4

Marker of hemoconcentration that appears to be the most accurate for predicting severity

Answer 4

Blood urea nitrogen

Question 5

Preferred test to image the pancreatic duct in chronic pancreatitis

Answer 5

MRCP

ERCP has high risk of pancreatitis

Question 6

Hallmark symptom of chronic pancreatitis

Answer 6

Abdominal pain

Question 7

Most important risk factor for pancreatic adenocarcinoma

Answer 7

Age greater than 50 years

Question 8

Hereditary pancreatitis causes cancer in up to 40% of affected patients and is associated with mutations in this gene

Answer 8

Cationic trypsinogen gene

Question 9

Most common site of metastasis of pancreatic cancer

Answer 9

Liver

Question 10

Lymphoplasmacytic infiltrates seen in organs affected by autoimmune pancreatitis are positive for this immunoglobulin G subclass

Answer 10

IgG4

Question 11

Also known as type II autoimmune pancreatitis, not related to IgG4 cell deposition; patients tend to be younger; often with IBD

Answer 11

Idiopathic duct-centric chronic pancreatitis

Question 12

Most common presentation of autoimmune pancreatitis

Answer 12

Painless obstructive jaundice

Question 13

Most commonly involved extrapancreatic organ in autoimmune pancreatitis

Answer 13

Biliary tree

Question 14

“Sausage-shaped” pancreas with featureless borders on CT scan is characteristic of this condition

Answer 14

Autoimmune pancreatitis

Question 15

Aside from histology, diagnosis of autoimmune pancreatitis can also be made by the finding of this number of IgG4-positive cells on immunostain of lymphoplasmacytic infiltrate with storiform fibrosis

Answer 15

Ten IgG4-positive cells per hpf

Question 16

Genetic disease associated with pancreatic cystic neoplasms

Answer 16

von Hippel-Lindau disease

Question 17

Most common cystic neoplasms of the pancreas

Answer 17

Intraductal papillary mucinous neoplasms (IPMN)

Question 18

Involvement of intraductal papillary mucinous neoplasms that have the highest malignant potential and should be resected

Answer 18

Main- and combined-duct IPMNs

Question 19

Side-branch intraductal papillary mucinous neoplasms do not require resection as long as they are of this size

Answer 19

<3 cm

Question 20

Pancreatic cysts with high levels of carcinoembryonic antigen (2)

Answer 20

IPMN and mucinous cystadenoma

Question 21

Morphologic features pathognomonic for a pancreatic serous cystadenoma (2)

Answer 21

Microcysts and a central scar

Question 22

Most common pancreatic neuroendocrine tumor

Answer 22

Gastrinoma

Question 23

Pancreatic neuroendocrine tumor that is least likely to metastasize

Answer 23

Insulinoma