Gall Bladder and Pancreas Flashcards
Describe the clinicopathologic findings in the common non-neoplastic gallbladder disorders Describe the clinicopathologic findings in the common non-neoplastic extrahepatic bile duct disorders Describe the pathologic features of common gallbladder tumors Describe the pathologic features of common extrahepatic bile duct tumors Describe the clinicopathologic findings in and causes of acute and chronic pancreatitis Describe the pathologic features common pancreas tumors (pseudocyst, adenocarci
most common type of gall-stones
cholesterol
make up of pigmented stones
bilirubin calcium salts
pathernogenesis of cholesterol genes
cholesterol supersaturates bile –> crystalizes out of solution + hypomobility of the gallbladder and mucus hypersecretion
major factor causing pigmented stones in US
sickle cell
ethnic group most predisopsed to cholesterol stones
native americans
5 fs of gallbladder risk
fat, fair, forty, fertile, female
stones that are mostly radiopaque
pigment
stones that arise excusivily in the gallbaldder
cholesterol
presentation of gallstones
RUQ pain that can be constant or sporadic
complications of gallstones
empyema, perforation, fistulas, pancreatitis, intestinal obstruction
gallbladder is enlarged and tense, bright red or blotchy, and covered by fibrinous exudate
acute cholecystits
present in most acute cholecystitis
gallstone obstructing neck of gallbladder or cystic duct
gallbladder lumen filled with mostly pus called
empyema of the gallbladder
green-black gallbladder
gangernous cholecystitis
acute inflammation of a gallbladder that contains stones is
acute calculous cholesystiitis
can cause non-stone cholecystitis
major surgery, trauma, severe burns, sepsis
upper abdominal pain that radiates to right shoulder with abdominal rigidity
acute calculous cholecystitis
nausea, vominiting and intolerance for fatty foods
chronic cholecystits
complications of cholecystitis
bacterial superinfection with cholangitis
perforation and abcess/peritonitis
billiary enteric fistula
aggravation of preexisting illness
precense of stones within the billiary tree
choledocholithiasis
acute inflammation of the bile ducts
cholangitis
causes of cholangitis
choledocholithiasis
surgery involving biliary tree
tumors, stents acute pancreatis
fever chills, abdominal pain and jaundice
bacterial cholangitis
risk of supperative cholangitis
liver abcess formation
prolonged obstruction of the extrahepatic biliary tree can cause
profound damage to the liver
neonatal cholestatis
biliary atresia
treatment of biliary atresia
transplant
most common type of cancer in gallbladder
adenocarcinoma
adenocarcinomas that arise from cholagiocytes lining intraheptic and extrahepatic biliary ducts
cholangiocarcinoma
lots if intracelylar mucin, but no bile pogment of hyaline inclusion
cholangiocarcinoma
major cause of acute pancreatitis
alchohol abuse or biliary disease
basic alterations in acute pancreatitis
microvasculatr leakage causing edema necrosis of fat by lipases acute inflammatory reaction proteolytic destriction of pancreatic parencyma insistial hemmorage
histological findings in acute pancreattis
fat necrosis and calcium salts
severe form of acute pancreatitis
necrotising
critical triggering event in acute pancreatis
activation of trypsin
three patheogenesis paths of acute pancreatitis
1) duct obstruction
2) primary acinar cell injury
3) defective intracellular transport of proenzymes within acinar cells
location of pain in acute pancreatitis
epigastric pain radiating to upper back
dx of acute pancretitis
elevated amylase and lipase in plasma
non-pain signs of acute pancreatitis
abdominal guarding, absence of bowel souds
sequalae of acute pancreatitis
abcesses or pseudocysts
most common cause of chronic pancreatitis
long-term EtOH abuse
morphology of chronic pancreatitis
parenchymal fibrosis
reduced number and size of acini
variable dilation of pancreatic ducts
imaging result of chronic pancreatitis
calicfcation
signs of chronic pancreatitis
jaundice, indigestion, recurrent abdominal or back pain
long term effects of chronic pancreatitis
DM, chronic malabsorption, severe chronic pain, cancer
common anecedent of pancreatic carcinoma
panceratic intraepithelelal neoplasias
most frequent ocogene in pancreatic cancer
KRAS
stongest enviromental risk of pancreatic cancer
smoking
most common site of pancreatic carcinoma
head
most common type of pancreatic carcinoma
ductal adenocarcinoma
desoplastic resonse
reaction to pancreatic carcinoma constiting of fibroblasts, lymphocytes, and extracelllar matrix
site of pancreatic carcinoma that tends to be silernt
body and tail
presentatin of pancreatic carcinoma
jaundice
weight los
anorexia
malaise and weakness
spotting sign of pancreatic carcinoma
migratory thrombophebitis
lab test used in pancreatic carcinoma
CA19-9