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Block 15 Ellen > L7: Biliary and pancreatic pathology > Flashcards

L7: Biliary and pancreatic pathology Flashcards

1
Q

in pancreatic cancer when the tumour grows it presses on

A

bile duct and side of duodenum

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2
Q

what produces bile

A

hepatocytes

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3
Q

where is bile stored

A

gall bladder

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4
Q

when you eat what enzymes stimulates bile release into bowel

A

CCK

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5
Q

where is most bile reabsorbed

A

terminal ileum

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6
Q

3 main parts of bile

A

bile acids
cholesterol
bilirubin

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7
Q

3 roles of bile

A

-emulsification of fats
-helps eliminate waste products
signalling molecules

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8
Q

3 waste products bile helps eliminate

A

excess cholesterol
bilirubin
non-water-soluble xenobiotics

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9
Q

what type of bilirubin arrives at the liver

A

uncongugated bilirubin

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10
Q

what type of bilirubin does the liver release

A

conjugated bilirubin

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11
Q

what type of bilirubin is reabsorbed

A

urobilinogen

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12
Q

where can urobilinogen go after reabsorption

A

kidney or liver

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13
Q

bilirubin secreted in bowel=

A

stercobiliogen

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14
Q

chalky white poo =

A

lack of stercobilinogen

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15
Q

urine goes dark

A

decreased urobiliogen (maybe increased cogugated bilirubin)

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16
Q

jaundice=

A

hyperbilirubinaemia

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17
Q

3 types of jaundice

A

prehepatic
hepatic
post-hepatic

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18
Q

4 causes of prehepatic jaundice

A
  • haemolysis
  • resorption from bleed
  • gilbert
  • ineffective erythropoesis
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19
Q

4 causes of hepatic (mixed) jaundice

A
  • liver disease
  • drugs
  • toxins
  • cancer
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20
Q

4 causes of post-hepatic jaundice

A
  • gallstones
  • Ca pancreas
  • Strictures
  • Biliaryatresia
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21
Q

gilberts syndrome=

A

congenital condition where uncojugated bilirubin struggles to get into the liver

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22
Q

what does the gallbladder do

A

concentrates bile 5-10 x

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23
Q

6 pathologies of the gallbladder

A
  • cholesterolosis
  • stones
  • cholecystitis
  • mucocoele
  • carcinoma
  • congenital abnormalities
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24
Q

3 types of stones

A

cholesterol
pigment
mixed

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25
Q

cholecystitis=

A

inflammation of gallbladder

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26
Q

main cause of cholecystitis=

A

stones

27
Q

5 causes of gallstones

A 
chronic haemolysis 
lithogenic bile 
inflammation/ infection 
rapid weight loss
stasis
28
Q

main type of gallstones

A

cholesterol stones

29
Q

3 Fs of gallstones

A

fat
fair
forty

30
Q

ERCP=

A

endoscopic retrograde cholangiopancreatography

31
Q

5 complications of gallbladder/ cystic duct gallstones

A

-cholecystitis
-mucocoele
-empyema
-perforation
gallstone ileus

32
Q

4 complications of gallstones in common bile duct

A
  • obstruction
  • pain
  • cholangitis
  • gallstone ileus
33
Q

main issue of gallstones in common bile duct

A

very painful

34
Q

how common are carcinoma of gallbladder/ bile duct

A

rare

35
Q

signs are symptoms of gallbladder carcinoma

A

few in early stages

36
Q

5 year survival for gallbladder carcinoma

A

<1%

37
Q

2 functions of pancreas

A

endocrine

exocrine

38
Q

exocrine pancreas–>

A

powerful digestive enzyme Trypsin, lipases and amylase

39
Q

endocrine pancreas–>

A

insulin and glucagon

40
Q

how does the pancreas develop embryonically

A

in two halves

41
Q

4 diseases of the pancreas

A

congenital anomalies
acute pancreatitis
chronic pancreatitis
tumours

42
Q

causes of acute pancreatitis (I GET SMASHED)

A 
idiopathic
gallstones
ethanol 
trauma 
scorpion sting
malignancy/ mumps 
autoimmune 
steroids
hyperlipidaemia/ hypercalcaemia
ERCP
drugs
43
Q

symptoms of acute pancreatitis

A
  • acute abdominal pain, central, severe often radiates to back
  • vomiting
44
Q

patient history in acute pancreatitis

A

alcohol excess

gallstones certain drugs

45
Q

sign of acute pancreatitis

A

guarding and tenderness in upper abdomen

46
Q

consequences of acute pancreatitis (4)

A 
abscess
pseudocyst 
relapse 
diabetes 
death
47
Q

commonest cause of chronic pancreatitis

A

alcohol

48
Q

6 other causes of chronic pancreatitis

A 
biliary tract disease 
hypercalcaemia 
hyperlipidaemia 
haemochromatosis 
cystic fibrosis 
idiopathic
49
Q

morphology of chronic pancreatitis

A

irregular gland with fibrosis, fatty infiltration, calcification

50
Q

what does the appearance of chronic pancreatitis mimic

A

carcinoma

51
Q

what part of the pancreas is relatively spared in chronic pancreatitis

A

endocrine pancreas

52
Q

outcomes of chronic pancreatitis (8)

A 
pain 
weight loss 
steatorrhoea 
diabetes 
jaundice 
hypoalbuminaemia 
pseudocysts 
splenic vein thrombosis
53
Q

a benign cystic tumour in the exocrine pancreas =

A

mucinous cystadenoma

54
Q

a malignant cystic tumour in the exocrine pancreas=

A

mucinous cystadenocarcinoma

55
Q

features of an exocrine pancreatic tumour

A

pseudocysts

pancreatic abscess

56
Q

where are most adenocarcinomas of the pancreas

A

in the head

57
Q

symptoms of carcinoma of the pancreas

A
  • often little

- weight loss, back pain, painless jaundice

58
Q

signs of pancreatic cancer

A

trousseau’s sign

59
Q

treatment of pancreatic carcinoma

A

surgery

chemotherapy

60
Q

medium survival of pancreatic carcinoma

A

2-3 months

61
Q

5 tumours of the endocrine pancreas

A 
islet cell tumours 
insulinoma
gastrinoma 
glucagonoma 
somatostatioma
62
Q

pre-hepatic jaundice–>

A

raised uncongugated bilirubin

normal everything else

63
Q

intra-hepatic jaundice–>

A 
increased conjugated bilirubin 
increased unconjugated bilirubin 
increased ALT, AST, GGT, ALP 
normal stool 
dark urine 
no itchy skin
64
Q

post hepatic jaundice–>

A

conjugated bilirubin
pale stool
dark urine
itchy skin

Block 15 Ellen (11 decks)

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