Lecture 10

Question 1

What are the 3 patholgies of pancrease?

Answer 1

Acute, chronic and cancer

Question 2

What are the cells of endocrine portion of pancrease and what about exocrine?

Answer 2

-Islets of langerhans are endocrine and Acini and ducts are the exocrine portion

Question 3

What causes exocrine diseases? what causes endocrine?

Answer 3

• Pancreatitis and autodigestion of pancrease via amylase, trypsin and lipase. also due to neoplasm
• Endocrine happens due to diabetes and neoplasm

Question 4

if you see an increase in amylase and lipase then it is? what are the etiology of that disease?

Answer 4

Probably acute pancreatitis

-etiology: gullstone and alcoholism are the two major causes. could be due to germline mutations

Question 5

Summariese acute pancreatitis pathogenisis?

Answer 5

all have to lead to acinar cell damage and activation of enzymes leading to self-digestion.

Question 6

What is the pathogenisis of acute pancreatitis?

Answer 6

-So its fat necrosis leading to fat cell release and combine it with calcium leading to dystrophic calcification

Question 7

What are the clinical features of acute pancreatitis?

Answer 7

• Pain
• Constant and intense and refer to upper back.
• NAusea and vomitting and fever,
• Serum amylase increase first 24 hour and lipase 72-96 hours.

Question 8

What are th systemic manifestation of acute pancreatitis?

Answer 8

-DIC, ARDS (acute respiratory distress syndrome, shock and acute renal failure.

Question 9

What is the treatment and prognosis of acute pancreatitis?

Answer 9

-usually supportive therapy and resting, 5% would die from shock but everyone is gonna be fine

Question 10

What are the manifestations of chronic pancreatitis?

Answer 10

• usually its the constant damage to exocrine pancrease until its irreverisbe followed by damage to islets of langerhans
• Grossly it will lead to atrophy, scarring and ductal concertion
• Gland atrophy and fibrosis

Question 11

What does finding drug concertion indicate?

Answer 11

Chronic pancreatitis due to alcoholism

-Protein rich stones and firbrosis and atrophy

Question 12

What is the etiology and prognosis of pancreatic ductal adenocarcinoma?

Answer 12

-Occurs with old age
-Smoking is high risk
-Inherited genetic defect BRCA2 gene.
Clinical features include
Weight loss,anorexia and general weakness, migatoratory thrmbophlebitis, new onset of diabetes

Question 13

What is the pathigenis and treatement of pancreatic ductal adenocarcinoma?

Answer 13

-Pancreatic intraepithelial newplasia.
=most common precurser arise in small ducts
-KRAS is the most activated oncogene!
-p16 is most common inactivated tumor supressor gene

== TREATMENT!
Whipple procedure and is usally only 20% are resectable at time of diagnosis. Chemotherapy not very efective

Question 14

What are the pancreatic cystic neoplasms?

Answer 14

-Pancreatice serous cystaadenoma
-Pancreatic mucinous cystic neoplasm
Interductal papilary mucinous neoplasm