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Y1 Gastrointestinal > Inflammation and Tumours of the Pancreas > Flashcards

Inflammation and Tumours of the Pancreas Flashcards

1
Q

what cells are found in the exocrine pancreas?

A

acinar cells

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2
Q

what does the exocrine pancreas secrete?

A

pancreatic digestive enzymes

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3
Q

what cells are found in the endocrine pancreas?

A

islets of langerhans

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4
Q

what does the endocrine pancreas secrete?

A

hormones

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5
Q

name the four different types of islets

A

beta cells
alpha cells
delta cells
F cells

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6
Q

what do beta cells secrete?

A

insulin

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7
Q

what do alpha cells secrete?

A

glucagon

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8
Q

what do delta cells secrete?

A

somatostatin

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9
Q

what do F cells secrete?

A

pancreatic polypeptide

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10
Q

what two things regulate pancreatic secretions?

A

the vagus nerve

gastrin levels

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11
Q

what three things are secreted from the acinar cells?

A

proteases
lipase
amylase

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12
Q

name two proteases secreted by the pancreas?

A

trypsin

chymotrypsin

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13
Q

what do proteases do?

A

breakdown polypeptides into peptides

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14
Q

what does lipase do?

A

breakdown triglycerides

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15
Q

what does amylase do?

A

breaks down carbohydrates into di/monosaccharides

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16
Q

what two things are secreted from the epithelial cells lining ducts in the pancreas?

A

bicarbonate

water

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17
Q

what is acute pancreatitis?

A

an acute inflammatory process in the pancreas

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18
Q

what mnemonic is used to remember the causes of acute pancreatitis?

A

I GET SMASHED

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19
Q

name all of the causes of acute pancreatitis

A 
idiopathic
gallstones
ethanol
trauma
steroids
mumps
autoimmune
scorpion bite 
hypercalcaemia and hyperlipidaemia 
ERCP
drugs
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20
Q

name a drug that can cause acute pancreatitis

A

azathioprine

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21
Q

where does pain from pancreatitis present?

A

the epigastrium

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22
Q

where does pain from pancreatitis radiate to?

A

the back

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23
Q

what can be associated with the pain from pancreatitis?

A

nausea
vomiting
jaundice

24
Q

what are bowel sounds like in pancreatitis?

A

normal

25
Q

what does fullness in the epigastrium in a patient with pancreatitis suggest?

A

a pseudocyst

26
Q

name three classic signs of acute pancreatitis

A

erythema ab igne
cullen’s sign
grey turner’s sign

27
Q

name four initial investigations for acute pancreatitis

A

bloods
ABG
USS
CT

28
Q

what blood result is diagnostic of acute pancreatitis?

A

amylase more than three times the upper limit of normal

29
Q

what is USS used for in patients with acute pancreatitis?

A

gallstones
CBD size
cholecystitis

30
Q

what is CT used for in patients with acute pancreatitis?

A

as follow up to assess the severity and to look for any complications

31
Q

when is the best time to do a CT in a patient with acute pancreatitis?

A

around 5 days after the onset of symptoms

32
Q

name five possible complications of acute pancreatitis

A 
fluid collections 
necrosis 
ascites 
bleeding 
abscess
33
Q

what should not be used to diagnose acute pancreatitis?

A

ERCP

34
Q

what can ERCP be used for?

A

treating gallstones

35
Q

what score on the glasgow criteria is considered to be severe pancreatitis?

A

more than 3

36
Q

how is acute pancreatitis managed initially?

A

fluid resuscitation
oxygen
antibiotics if needed

37
Q

what can pancreatic pseudocysts cause?

A

biliary and gastric outlet obstruction

38
Q

how does a pancreatic pseudocyst present?

A

pain
nausea & vomiting
jaundice
weight loss

39
Q

how is a pancreatic pseudocyst treated?

A

drainage or resection

40
Q

what three methods of drainage can be used on a pancreatic pseudocyst?

A

endoscopic
radiological
surgical

41
Q

why are pancreatic abscesses drained?

A

to control sepsis

42
Q

how is a pancreatic abscess drained?

A

using CT/US guided retro/transperitoneal drainage

43
Q

what imaging can be used to assess pancreatic necrosis?

A

CT

44
Q

what two states can pancreatic necrosis be in?

A

sterile

infected

45
Q

what is chronic pancreatitis?

A

progressive and irreversible damage causing a loss of exocrine and/or endocrine function

46
Q

how does chronic pancreatitis present?

A

same as acute, with masses, ascites or jaundice on examination

47
Q

name five investigations that can be done for chronic pancreatitis?

A 
x-ray
ultrasound 
CT
MRI
ERCP
48
Q

name five causes of chronic pancreatitis

A 
alcohol
idiopathic
pancreatic duct obstruction
autoimmune 
hereditary
49
Q

what should be used to treat pancreatitis if there is pancreatic insufficiency?

A

creon as enzyme replacement

50
Q

what do surgical procedures can be done to treat chronic pancreatitis?

A

pustow procedure

frey procedure

51
Q

name an exocrine tumour of the pancreas

A

adenocarcinoma

52
Q

name three endocrine tumours of the pancreas

A

gastrinoma
insulinoma
glucagonoma

53
Q

what does a gastrinoma do?

A

produces gastrin and increases stomach acid

54
Q

what does an insulinoma do?

A

produces insulin and causes hypoglycaemia

55
Q

what does a glucagonoma do?

A

produces glucagon, causing hyperglycaemia

56
Q

what investigations can be done for pancreatic cancers?

A

ultrasound
CT
MRI
MRCP

Y1 Gastrointestinal (48 decks)

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