Histopath - pancreas + gall bladder

Question 1

top causes of acute pancreatitis

Answer 1

Gallstones
Alcohol
Tumours

Others: trauma, thiazides, hypercalcemai, hyperlipidemia, mumps,

Question 2

How does EtOh lead to pancreatic duct obstruction

Answer 2

EtOh –> sphincter of oddi vasospasm –>pancreatic fluid is thick and obstructs the pancreatic ducts

Question 3

Periductal inflammation in acute pancreatitis suggests…

Answer 3

Cause = duct obstruction

Question 4

Perilobular inflammation in acute pancreatitis suggests…

Answer 4

Cause = poor blood supply

Question 5

Yellow white foci in a pancreas with acute inflammation - why?

Answer 5

Lipase released –> fat necrosis

FFAs are then bound by Calcium ions

Question 6

Pancreas related complications of acute pancreatitis

Answer 6

Pancreas: Pseudocysts, abscesses

Question 7

Systemic complications of acute pancreatitis

Answer 7

Shock
Hypoglycaemia
Hypocalcemia

Question 8

Chronic pancreatitis - 50% of cases are associated with…

Answer 8

Acute pancreatitis

Question 9

80% of chronic pancreatitis is caused by

Answer 9

ETOH

Question 10

Pattern of injury in chronic pancreatitis:
in ducts?
in parenchyma?

Answer 10

ducts - strictures –> secondary dilatation

Parenchymal tissue is lost and replaced by fibrotic tissue

Question 11

Complications of chronic pancreatitis

Answer 11

DM
Malabsorption
Pseudocysts
Pancreatic ca

Question 12

X-ray appearance of chronically inflamed pancreas

Answer 12

Multiple calcifications

Question 13

Palpable mass in abdomen following acute pancreatitis

Answer 13

pancreatic pseudocyst

Question 14

Histology shows duct ectasia - is this pancreas acutely or chronically inflamed?

Answer 14

Chronically

Question 15

WTf is a pseudocyst

Answer 15

Lined by fibrotic tissue

Filled with pancreatic enzymes = necrotic material

Question 16

Autoimmune pancreatitis is characterised by…?

Answer 16

IgG4 cells

Question 17

IgG4 plasma cells

Answer 17

Autoimmune pancreatitis

Question 18

Most common form of pancreatic tumour

Answer 18

Ductal

Question 19

3 main groups of pancreatic tumours

Answer 19

Carcinomas
Cystic
Neuroendocrine tumours

Question 20

Ductal pancreatic cancer - survival? gender?

Answer 20

Men = 2x more affected

5% survival in 5 years

Question 21

Pre-malignant form of ductal carcionma

Answer 21

PANIN = pancreatic intraductal neoplasia

Question 22

Mutation present in vast majority of ductal carcinoma patients?

Answer 22

K-Ras

Question 23

Microscopic appearance of ductal carcinoma

Answer 23

most are adenocarcinomas, with mucin secreting glands

Question 24

vascular complication of ductal pancreatic carcionma

Answer 24

Migratory thrombophlebitis = venous thrombosis

Question 25

2 types of cystic pancreatic tumours

Answer 25

Serous

Mucinous

Question 26

Pancreatic neuroendocrine neoplasms are associated with a syndrome…

Answer 26

MEN1 syndrome = multiple endocrine neoplasia type 1

Question 27

Commonest type of pancreatic secretory tumour

Answer 27

Insulinoma

Question 28

Rokitansky Aschoff sinuses - what are they and when are they seen

Answer 28

Chronic cholecystitis

Diverticulae in the gall bladder