Exocrine Pancreas Pathology Flashcards
What are the top Metabolic Etiologies of Acute pancreatitis?
ALCOHOLISM Hyperlipoproteinemia Hypercalcemia Drugs Genetic
What are the top Mechanical Etiologies of Acute pancreatitis?
Galstones Trauma Iatrogenic Injury -Perioperative -Endoscopic Pocedres with dye injection
What are the top Vascular Etiologies of Acute pancreatitis?
Schock
Atheroembolism
Vasculitis
What are the top Infectious Etiologies of Acute pancreatitis?
Mumps
Coxsackievirus
Mycoplasma Pneumoniae
What Pancreatic Enzymes are released that cause pathology in pancreatitis?
Proteases(Proteolysis)
Lipase (Fat Necrosis)
Phospholipase
ELastase(hemorrhage)
What is the most diagnostic enzyme secreted by the pancreas?
Pancreatic Lipase
Where does pancreatitis refer pain to?
Acute Epigastric Pain
Mid Back
What is the main difference between Serum Lipase and Amylase?
Amylase peaks sooner
Lipase lasts longer (7-14 days)
Waht are the aspects of pancreatitis that are responsible for its high mortality?
Acute Pain, Shock, ARDS, Hypocalcemia
What versions of Pancrreatitis are most serious?
Acute Necrotizing p. Bad
Hemmhoragic p. Bad
Acute Interstitial p.
What is so bad about Nec. Panc and Hem. Panc.?
Inflammatory Mediators, and activated enzymes
- leukocytosis
- DIC
- fluid sequestration
- diffuse fat necrosis
- ARDS
- SHOCK and ACUTE TUBULAR NECROSIS
- vasoactivators => Vasodilation=> Dec BP
Sequelea of Acute Pancreatitis
Sterile abcess
Pseudocyst-Collection of blood, debris, tissue, fluid
infected Pancreatic Necrosis
What cellular markers are released in chronic pancreatitis?
TGFBeta
PDGF
Collagen secretion ECM Growth Factor
What is the main change in the pancreas caused by chronic pancreatitis
Diffuse Fibrosis and decrease in glandular activity.
What mutations are causes of chronic Pancreatitis?
PRSS1 and SPINK1
What is the most common cause of Chron Panc at a young age?
Cystic Fibrosis (CFTR gene mutation)
What is the most common cause of Chron Panc?
Alcohol abuse
Idiopathic
Gallstones
Waht is the cellular morphology of Chronic Pancreatitis?
Acinar cell Drop out
Chronic Inflammatory infiltrate
Marked Fibrosis
Protein Precipitates
What is the classical triad of progressive inflammatory disease of the pancreas?
Diabetes
Steatorrhea
Calcifications
also permanent impairment of function
Irreversible morphologic changes
Where is the mutation associated with Von Hipple Lindau Syndrome
Chromosome 3
What is the congenital disorder that leads to cysts in the pancreas, liver, and kidneys.
Von-Hippel-Lindau Syndrome
What are the different types of Cystic Tumors?
Microcystic serous cystadenoma
Mucinous cystic tumors
Solid Pseudopapillary Tumor
Intraductal Pappillary Mucinous neoplasms
What is the danger of Intraductal Pappillary Mucinous neoplasms?
They can grow and obstruct the pancreatic ducts and eventually become cancerous
What is the difficulty with diagnosing Pancreatic cancer?
None of the symptoms are specific to the pancreas?
What gene does smoking stimulate to cause pancreatic cancer?
K-Ras
What is the biggest environemental risk factor for pancreatic cancer?
Smoking
Where is the most common place for Pancreatic cancer to arise?
In the head of the pancreas(60%)
Where is the most common site of mets of Panc. Cancer?
Liver
lung
peritoneum
What demographic has Gallstones more often?
Native Americans
Mexicans
Northern Europe
N/S America
What is Accretion?
The formation of a Gallstone
What causes Pigmented Gallstones?
Chronic Hemolytic Syndrome
BT infection
Ileal Disease
Ca Precipitation of Bili
What causes Cholesterolosis/ strawberry gallblader?
High Cholesterol Diet or hyperlipidemia
What causes Chronic Cholecystitis?
Long standing inflammation of the GB
Accumulated damage of Acute attacks
Chronic infection
What is the appearance of Chronic Cholecystitis?
Thickenign of the GB wall and infiltration of inflammatory cells
What are the complications of Cholecystitis?
Bacterial Superinfection
GB Perforation Abcess
GB rupture and Peritonitis
Biliary eteric fistula-gallstone induced intestinal obstruction
