Lecture 8 - Pancreas

Question 1

first enzyme activated in pancreatitis?

what can activate this?

Answer 1

trypsin;

calcium

Question 2

2 biggest causes of acute pancreatitis?

Answer 2

alcohol, gall stones;

Question 3

classic case of trauma causing acute pancreatitis?

what viral illness can cause it?

Answer 3

kids in car accident (Seat belt);

mumps

Question 4

2 “hypers” that can cause acute pancreatits

Answer 4

triglyceridemia;

calcemia

Question 5

2 types of necrosis in pancreatitis

Answer 5

liqeufactive hemorragic necrosis of pancreas;

fat necrosis of peripancreatic fat

Question 6

3 criteria for diagnosis of acute pancreatitis:
acute _____ pain radiating to the _____:
increased ____ or ____ (which is more specific?);
characteristic ______

Answer 6

epigastric, back;
amylase, lipase (lipase!);
findings on imaging (pancreas surrounded by edema)

Question 7

liqeufactive necrosis can spread to…
grey-turner’s sign = ____;
cullen’s sign = ____ regions

Answer 7

retroperitoneal (flank hemorrhage), periumbilical

Question 8

pancreatitis complications:
____ (lung);
abcess due to ____;
____Calcemia

Answer 8

ARDS;
E. coli;
hypo

Question 9

most common cause chronic pancreatitis:

Answer 9

chronic alcohol use

Question 10

characteristic finding of chronic pancreatitis on imaging?

Answer 10

“chain of lakes” due to dilatation of ducts

Question 11

classic triad of chronic pancreatitis diagnosis:

Answer 11

calcifications + steatorrhea + diabetes mellitus

Question 12

amylase and lipase are usually ____ in chronic pancreatitis

Answer 12

normal

Question 13

pancreatic cancer:
2 important risk factors:
africans americans or whites?

Answer 13

smoking, chronic pancreatitis;

africans americans

Question 14

pancreatic cancer:
usually located where in the pancreas?
what symptoms does this cause?

Answer 14

head of pancreas;

–> obstructive jaundice with palpable, non-tender gall bladder (pale stools)

Question 15

classic presentation (According to pathoma):
secondary \_\_\_\_ in a \_\_\_\_ \_\_\_\_ person, if located in the \_\_\_\_ of the pancreas

Answer 15

diabetes, thin elderly;

head/tail

Question 16

pancreatic cancer:

what is trousseau syndrome?

Answer 16

migratory thromboplebitis (due to hypercoaguable state)

Question 17

pancreatic cancer:
____ pain radiating to the ____, especially at ____;
weight ____

Answer 17

epigastric, back, night;

loss

Question 18

tumor marker associated with pancreatic cancer:

Answer 18

CA 19-9

Question 19

what does the whipple procedure remove?

Answer 19

head and neck of pancreas, gall bladder, proximal duodenum