Gallbladder and Pancreas Path Flashcards
What is acute pancreatitis?
a group of reversible lesions characterized by inflammation of the pancreas ranging in severity from edema and fat necrosis to parenchymal necrosis with severe hemorrhage
What are the top two etiologies of acute pancreatitis?
Alcoholism
Hyperlipoproteinemia
What drugs can lead to acute pancreatitis?
Thiazide diuretics
What genetic mutations can lead to acute pancreatitis?
PRSS1 (trypsinogen) or SPINK1 (trypsin inhibitor
What are the three major mechanical causes of acute pancreatitis?
Gallstones
Trauma
iatrogenic injury
What are the three vascular etiologies of acute pancreatitis?
Shock
Atheroembolism
vasculitis
What are the three infectious etiologies of acute pancreatitis?
Mumps
Coxsackie virus
Mycoplasma pneumoniae
What is the cell in the pancreas that release trypsin? What does this cause when these cells are damaged?
Acinar cells
Premature activation of enzymes, causing pancreatitis
What enzyme in the pancreas produce hemorrhage?
elastase
What enzyme causes the fat necrosis of acute pancreatitis?
Lipase
What is the intrinsic cause of pancreatitis within acinar cells?
Defective transport failure to bring out enzymes
What are the two enzymes that are released with pancreatic acinar cell damage?
Lipase
Trypsin
What is the role that Ca plays in pancreatitis?
Ca activates enzymes–thus the hypocalcemia that can be seen in acute pancreatitis
What is the significant sequelae of acute pancreatitis?
Shock
What is the significant sequelae with the fat necrosis seen in acute pancreatitis?
Hypocalcemia
What is the time frame difference between lipase and amylase?
Amylase peaks first, then lipase
Increase in amylase that lasts >7 days, suggests what?
Pancreatic pseudocyst
What is the cause of renal failure with acute pancreatitis?
Enzyme activation hurts the tubules
What is the cause of ARDS with acute pancreatitis?
Elastase will degrade the lung BM
What is acute interstitial pancreatitis?
Inflammation and edema
What are the three morphologies of acute pancreatitis?
Interstitial
Necrotizing
Hemorrhagic
What is the cause of hemorrhagic pancreatitis?
Elastase degrades arteries
What are the systemic effects of acute pancreatitis?
Leukocytosis
DIC
Shock
What is the color of the Ca that builds up in acute pancreatitis with staining?
Blue
What is a pancreatic pseudocyst?
Collection of blood, enzymes, and debris
What is the difference between a pancreatic pseudocyst, and an abscess?
Abscess has an epithelial lining, and is filled with bacteria. Pseudocysts do not.
What is the definition of chronic pancreatitis?
Irreversible loss of exocrine pancreas
What are the main cytokines that are released with chronic pancreatitis? What does this cause?
TGF-b
PDGF
Fibrosis about the acinar cells
What is the main histological difference between acute and chronic pancreatitis?
Fibrosis