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Endocrine-Week 3/4 > Endocrine Pancreas > Flashcards

Endocrine Pancreas Flashcards

1
Q

The pancreas develops from the (foregut/midgut/hindgut)

A

Foregut (duodenum)

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2
Q

The pancreas develops from the (endoderm/mesoderm/ectoderm)

A

Endoderm

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3
Q

The pancreas actually forms from the fusion of a Ventral and Dorsal bud (True or False)

A

True; failure to fuse causes Pancreatic Divisum

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4
Q

What ducts drain directly into the Main Pancreatic Duct (2 total)

A

Ampulla of Vater

Common Bile Duct

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5
Q

Rare condition in which the duodenum is surrounded by a ring of pancreatic tissue continuous with the head of the pancreas; can constrict the duodenum and block or impair the flow of food to the rest of the intestines

A

Annular Pancreas

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6
Q

Failure of the Ventral and Dorsal ducts of the pancreatic buds to fuse; can make prone to pancreatitis due to obstruction

A

Pancreatic Divisum

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7
Q

The pancreas is (intraperitoneal/retroperitoneal)

A

Retroperitoneal

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8
Q

The pancreas is (anterior/posterior) to the Aorta and IVC

A

Anterior

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9
Q

The Islets of Langerhans compose _____ % of the pancreatic mass

A

1-2

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10
Q

D1 cells of the pancreas secrete what hormone

A

Vasoactive Intestinal Polypeptide

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11
Q

Enterochromaffin cells of the Pancreas secrete what hormone

A

Serotonin

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12
Q

Epsilon cells of the Pancreas secrete what hormone

A

Ghrelin

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13
Q

Cells of the Islets of Langerhans; compose 20% of the islet; synthesize and secrete Glucagon; located along periphery of islet

A

Alpha

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14
Q

Cells that line the majority of the periphery of the Islets of Langerhan

A

Alpha (glucagon)

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15
Q

Cells of the Islets of Langerhans; compose 70% of the islet; synthesize and secrete Insulin; located in the center of islet

A

Beta

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16
Q

Cells that compose the majority of the center of the Islets of Langerhan

A

Beta (insulin)

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17
Q

Type (1/2) Diabetes Mellitus is hyperglycemia associated with the autoimmune destruction of Beta cells; little to no insulin; LEAST common; onset BEFORE age 20

A

Type 1

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18
Q

Type (1/2) is autoimmune

A

Type 1

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19
Q

Type (1/2) Diabetes Mellitus is hyperglycemia usually associated with obesity and genetics; combination of Insulin resistance; onset AFTER age 20

A

Type 2

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20
Q

Type (1/2) is usually associated with obesity

A

Type 2

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21
Q

Type (1/2) Diabetes Mellitus is more common

A

Type 2

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22
Q

Lymphocytic infiltrate in and around the Islets of Langerhan; seen in Type 1 Diabetes Mellitus

A

Insulitis

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23
Q

Type 1 Diabetes Mellitus manifests with symptoms when around _____% of the Beta cells are lost

A

90 (common trend with endocrine disorders, can compensate tremendously)

24
Q

Type 2 Diabetes Mellitus is associated with the deposition of….

A

amyloid (composed of Amylin, the hormone secreted with Insulin)

25
Q

The deposition of Amylin in the pancreatic Islets of Langerhan is diagnostic of Diabetes Mellitus (True or False)

A

False: can be seen in older people that don’t have Diabetes Mellitus

26
Q

Group of genetic disorders featuring benign and malignant neoplasms of neuroendocrine glands; AD dominance

A

Multiple Endocrine Neoplasia (MEN)

27
Q

The inheritance of MENs is…

A

Autosomal Dominance

28
Q

Tumors seen with MEN1 (3 total)

A

Pituitary tumors
Parathyroid tumors
Pancreatic Neuroendocrine tumors

29
Q

Type of mutation seen with MEN1

A

Loss of function for Tumor Suppressor

GENE: MEN 1

30
Q

Tumors seen with MEN2A (3 total)

A

Parathyroid tumors
Pheochromocytoma
Medullary Thyroid Carcinoma

31
Q

Type of mutation seen with MEN2A and MEN2B

A

Gain of Function for Proto-oncogene

GENE: RET

32
Q

Tumors/findings seen with MEN2B (4 total)

A

Pheochromocytoma*
Medullary Thyroid Carcinoma*
Marfanoid Body Type
Mucosal Neuromas

*same as MEN2A

33
Q

How to diagnose Familial Medullary Thyroid Carcinoma (which is different than MTC caused by MEN 2A or B)

A

1) find Medullary Thyroid Carcinoma
2) without other features of MEN2A/B

(that easy)

34
Q

Pancreatic (Neuroendocrine/Adenocarcinoma) tumors are far more common

A

Adenocarcinoma (neuroendocrine tumors are less than 10%)

35
Q

Pancreatic Neuroendocrine tumors are associated with which MEN

36
Q

Pancreatic (Microadenomas/Neuroendocrine) tumors are usually benign and less than 5mm in diameter

A

Microadenomas

Neuroendocrine tumors are usually large and metastatic

37
Q

Pancreatic (Microadenomas/Neuroendocrine) tumors are usually metastatic and more than 5mm in diameter

A

Neuroendocrine

Microadenomas are usually small and benign

38
Q

Neuroendocrine tumors are commonly described as having _____, ______, or _____ histologic pattern and __________ chromatin pattern.

A
  1. Solid/nested
  2. Trabecular
  3. Acinar
  4. Salt and pepper
39
Q

How to diagnose malignancy of Pancreatic Neuroendocrine Tumors

A

Invasion into peripancreatic tissues
OR
Presence of metastatic disease

*cytologic atypia not enough

40
Q

Examples of Functioning Pancreatic Neuroendocrine tumors (5 total)

A 
Insulinoma
Glucagonoma
Gastrinoma
Somatostatinoma
VIPoma
41
Q

Functioning Pancreatic Neuroendocrine tumor; insulin-secreting neoplasm of Beta-cells; MOST COMMON; signs and symptoms of Severe Hypoglycemia (confusion, lethargy, coma, etc.); usually SMALL (<3cm) and solitary; DOESN’T invade or metastasize

A

Insulinoma

42
Q

Insulinomas are usually (small/big), (solitary/multiple), and (bening/malignant)

A

Small (<3cm)
Solitary
Benign

43
Q

Most common Functioning Pancreatic Neuroendocrine tumor

A

Insulinoma

44
Q

What causes the signs/symptoms of Insulinomas

A

Severe Hypoglycemia (confusion, lethargy, coma, etc.)

45
Q

Insulinomas usually (do/don’t) metastasize and invade adjacent structures

A

Don’t

*only functioning pancreatic neuroendocrine tumor that doesn’t

46
Q

Functioning Pancreatic Neuroendocrine tumor of “G cells”, secreting Gastrin; most commonly seen in Duodenum; NOT FOUND in NORMAL islets of langerhans; INDUCES ACID SECRETION from parietal cells; can cause Zollinger-Ellison Syndrome (severe ulcers that go beyond into jejunum due to high acid); most are MALIGNANT

A

Gastrinoma

47
Q

Gastrinomas are usually (benign/malignant)

48
Q

Zollinger-Ellison Syndrome causes what changes in the stomach lining

A

Hypertrophic gastric folds caused by parietal cell hyperplasia (due to constant stimulation by Gastrin)

49
Q

Gastrinomas can cause what peptic ulcer syndrome

A

Zollinger-Ellison Syndrome (peptic ulcers well beyond duodenum into jejunum)

50
Q

Functioning Pancreatic Neuroendocrine tumor of Alpha cells, secreting Glucagon; RARE and MALIGNANT; results in hyperglycemia; symptoms include Diabetes, Necrolytic Migratory Erythema, Anemia

A

Glucagonoma

51
Q

Glucagonomas are usually (benign/malignant)

52
Q

Special dermatologic finding for Glucagonomas

A

Necrolytic Migratory Erythema

53
Q

Functioning Pancreatic Neuroendocrine tumor of “Delta (D) cells”, secreting Somatostatin; RARE and MALIGNANT; inhibits BOTH insulin and glucagon release; results in gallstones, steatorrhea (fatty stool) and hypochlorhydria (low stomach acid)

A

Somatostatinomas

54
Q

Signs/Symptoms of Somatostatinomas

A

Gallstones (no motility)
Steatorrhea (no bile)
Hypochlorhydria (no acid)

55
Q

Which Functioning Pancreatic Neuroendocrine tumors are MALIGNANT (4 total)

A

Gastrinomas
Glucagonomas
Somatostatinomas
VIPomas

56
Q

Functioning Pancreatic Neuroendocrine tumor of D1 cells, secreting Vasoactive Intestinal Polypeptide; RARE and MALIGNANT; results in Verner-Morrison Syndrome (watery diarrhea, hypokalemia, and hypochlorhydria)

57
Q

Signs/Symptoms of VIPoma

A

Verner-Morrison Syndrome:

  • Explosive/watery diarrhea
  • Hypokalemia
  • Hypochlorhydria

Endocrine-Week 3/4 (9 decks)

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