Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SURGERY (3RD YEAR) > PANCREAS 1.2 > Flashcards

PANCREAS 1.2 Flashcards

1
Q

What is a common intrapancreatic complication of chronic pancreatitis?

A

Pseudocysts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What complications can arise from pseudocysts?

A

Duodenal or gastric obstruction, thrombosis of splenic vein, abscess, perforation, and erosion into visceral artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some possible outcomes of an inflammatory mass in the head of the pancreas?

A

Bile duct stenosis, portal vein thrombosis, and duodenal obstruction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can duct strictures and/or stones cause in chronic pancreatitis?

A

Ductal hypertension and dilatation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of cancer is a complication of chronic pancreatitis?

A

Pancreatic carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some extrapancreatic complications of chronic pancreatitis?

A

Pancreatic duct leak with ascites or fistula, pseudocyst extension beyond lesser sac into mediastinum, retroperitoneum, lateral pericolic spaces, pelvis, or adjacent viscera.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a pancreatic pseudocyst?

A

A chronic collection of pancreatic fluid surrounded by non-epithelialized walls of granulation tissue and fibrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What percentage of acute and chronic pancreatitis cases develop a pseudocyst?

A

10% in acute pancreatitis and 20-38% in chronic pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is surgery indicated for a pancreatic pseudocyst?

A

If the pseudocyst is >6 cm and persists for >6 weeks for cystic wall maturation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most important cause of pancreatic pseudocyst formation?

A

Pancreatitis (75%), followed by trauma (25%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What complication can arise if a pseudocyst ruptures during the acute phase and surgery is performed?

A

The patient may become toxic due to the risk of rupture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a common diagnostic tool for detecting pseudocysts?

A

CT scan, as it reveals well-circumscribed, usually round or oval peripancreatic fluid collections with a well-defined enhancing wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What indicates a pancreatic abscess?

A

Presence of gross purulence (pus) with bacterial or fungal organisms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is peripancreatic fluid collection?

A

A collection of enzyme-rich pancreatic juice that occurs early in acute pancreatitis or from a pancreatic duct leak, lacking a well-organized wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is early pancreatic (sterile) necrosis?

A

A focal or diffuse area of nonviable pancreatic parenchyma, typically >30% of the gland with liquefied debris and fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an acute pseudocyst?

A

A collection of pancreatic juice enclosed within a perimeter of granulation tissue, usually occurring within 3-4 weeks of acute pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a chronic pseudocyst?

A

A collection of pancreatic fluid surrounded by a wall of normal granulation and fibrous tissue, usually persisting for >6 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment goal for a pancreatic pseudocyst?

A

For the cystic wall to resolve within 6 weeks at <6 cm; if >6 weeks and >6 cm, surgery may be considered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the purpose of internal drainage in pseudocyst treatment?

A

To create a connection between the pseudocyst and the stomach for cystic fluid drainage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is pancreatic ascites?

A

Leakage of pancreatic fluid into the peritoneal cavity without forming a pseudocyst.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are typical clinical manifestations of pancreatic ascites?

A

Progressive abdominal swelling, low serum albumin, and a history of chronic pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can ERCP reveal in pancreatic ascites?

A

The location of the pancreatic duct leak and the underlying ductal anatomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for a central pancreatic duct leak?

A

A Roux-en-Y pancreaticojejunostomy performed at the site of duct leakage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a pancreatico-enteric fistula?

A

An abnormal connection between the pancreas and an adjacent hollow organ, often due to a ruptured pancreatic pseudocyst.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common site of communication in pancreatico-enteric fistulas?

A

The transverse colon, splenic flexure, or descending colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What symptoms are associated with a pancreatico-enteric fistula involving the colon?

A

GI or colonic bleeding and sepsis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When might a pancreatico-enteric fistula close spontaneously?

A

If it communicates with the stomach or duodenum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the general medical treatments for chronic pancreatitis?

A

Lifestyle changes (no alcohol or smoking), diet modification (small, low-fat meals), NSAIDs and narcotics for analgesia, enzyme replacement (30,000 IU lipase per meal), and antisecretory agents (somatostatin, octreotide).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the interventional procedures for chronic pancreatitis pain?

A

Neuroablation (celiac plexus block, splanchnicectomy), decompression (endoscopic stenting, Puestow procedure), and resection (Whipple, Frey procedure).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What endoscopic treatments are available for chronic pancreatitis?

A

Stricture dilatation, stone extraction, stent placement, shock wave lithotripsy, internal drainage (cystogastrostomy, cystoduodenostomy, or cystojejunostomy).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the purpose of Duval-Zollinger’s procedure in chronic pancreatitis treatment?

A

It is a caudal pancreaticojejunostomy that creates a connection between the pancreas and jejunum for drainage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the Puestow-Gillesby procedure?

A

It is a longitudinal Roux-en-Y pancreaticojejunostomy that involves removing part of the tail of the pancreas, opening the pancreatic duct, and connecting it to the jejunum to drain pancreatic juice.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the Partington-Rochelle procedure?

A

It is a modification of the Puestow-Gillesby procedure, a longitudinal pancreaticojejunostomy that does not involve a caudal pancreatectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are drainage surgeries for chronic pancreatitis?

A

Drainage surgeries connect the pancreas to the jejunum to allow pancreatic juice drainage. Examples include Duval-Zollinger, Puestow-Gillesby, and Partington-Rochelle procedures.

35
Q

What is the Fry and Child procedure?

A

It is a 95% distal pancreatectomy that preserves the rim of the pancreas in the pancreaticoduodenal groove, along with associated blood vessels and the distal common bile duct.

36
Q

What is the Kausch-Whipple procedure?

A

It is a pancreaticoduodenectomy often used in chronic pancreatitis or pancreatic malignancy; includes duodenojejunostomy, pancreaticojejunostomy, and choledochojejunostomy.

37
Q

What is the difference between standard and pylorus-sparing Whipple procedures?

A

The standard Whipple involves distal gastrectomy, while the pylorus-sparing version preserves the pylorus for a less invasive approach.

38
Q

What is the hybrid Beger procedure?

A

It is a duodenum-preserving pancreatic head resection (DPHR) that preserves the duodenum while reducing pancreatic head pressure.

39
Q

What is the Frey and Smith procedure?

A

It involves local resection of the pancreatic head with longitudinal pancreaticojejunostomy (LR-LPJ) to decompress the entire pancreatic ductal system.

40
Q

What is the Hamburg modification?

A

It is a modification of the Frey and Smith LR-LPJ procedure with a wider excavation of the pancreatic head, followed by a single side-to-side pancreaticojejunostomy.

41
Q

What is the Berne modification?

A

It is a modification of the Beger procedure with excavation of the central portion of the pancreatic head without formal division of the pancreatic neck.

42
Q

What is the purpose of the Whipple procedure in chronic pancreatitis?

A

It removes the inflamed head of the pancreas and reconnects the pancreatic, bile, and digestive tracts to relieve symptoms and improve quality of life.

43
Q

How does the Partington-Rochelle procedure differ from other drainage surgeries?

A

It modifies the Puestow-Gillesby procedure by only excising necrotic tissue without making an opening in the pancreas, connecting healthy pancreas to normal bowel.

44
Q

Why is the Puestow-Gillesby procedure used?

A

It allows pancreatic juice to drain from the pancreatic duct by creating a connection to the jejunum after resecting the tail and opening the duct longitudinally.

45
Q

What are the three connections made in the Whipple procedure?

A

Duodenojejunostomy, pancreaticojejunostomy, and choledochojejunostomy.

46
Q

What is the goal of endoscopic internal drainage in chronic pancreatitis?

A

To drain pancreatic fluid collections or pseudocysts by connecting them to the gastrointestinal tract, such as with cystogastrostomy or cystoduodenostomy.

47
Q

What is the primary medical goal of treating chronic pancreatitis?

A

To relieve pain, manage enzyme insufficiency, and prevent complications through lifestyle changes, enzyme replacement, and, when necessary, interventional procedures.

48
Q

What is the dual role of the pancreas?

A

“The pancreas is both an exocrine and endocrine gland.”

49
Q

Which type of pancreatic neoplasm is more unfavorable, exocrine or endocrine?

A

“Endocrine neoplasm is more unfavorable due to hormonal imbalance.”

50
Q

What is the most common endocrine pancreatic tumor?

A

“Insulinoma.”

51
Q

What is Whipple’s Triad for insulinoma?

A

“Symptomatic fasting hypoglycemia

52
Q

How is insulinoma diagnosed?

A

“Low blood sugar

53
Q

What is the treatment for insulinoma located close to the main pancreatic duct?

A

“Distal pancreatectomy or pancreaticoduodenectomy if >2 cm and near main duct.”

54
Q

What are the key features of gastrinoma?

A

“Hyperacid secretion and peptic ulcer.”

55
Q

What syndrome is associated with gastrinoma?

A

“Zollinger-Ellison Syndrome (ZES).”

56
Q

What is the diagnostic marker for gastrinoma?

A

“Serum gastrin >1000 pg/mL

57
Q

What is Passaro’s triangle?

A

“An anatomic region typical for gastrinoma location

58
Q

What syndrome is associated with VIPoma?

A

“Watery diarrhea

59
Q

What is the diagnostic marker for VIPoma?

A

“Serum vasoactive intestinal peptide (VIP) levels.”

60
Q

What are the characteristics of glucagonoma?

A

“Diabetes with dermatitis

61
Q

What is the usual location of glucagonoma?

A

“Body and tail of the pancreas.”

62
Q

What is the diagnostic marker for somatostatinoma?

A

“Serum somatostatin >10 ng/mL.”

63
Q

What is the most common histology of pancreatic cancer?

A

“Adenocarcinoma.”

64
Q

What is the prognosis of pancreatic cancer?

A

“Worst prognosis among malignancies

65
Q

What is the most commonly mutated gene in pancreatic cancer?

A

“K-ras oncogene

66
Q

What is the imaging choice for pancreatic cancer?

A

“Dynamic contrast-enhanced CT scan.”

67
Q

What is the main curative treatment for pancreatic cancer?

A

“Pancreaticoduodenectomy (Whipple procedure).”

68
Q

What are the three bypasses in the Whipple procedure?

A

“Gastrojejunostomy

69
Q

What is a palliative option for biliary obstruction in unresectable pancreatic cancer?

A

“Endoscopic biliary metal stent

70
Q

What type of pancreatic lesion presents as a fluid-containing structure?

A

“Cystic neoplasms of the pancreas.”

71
Q

What is the prognosis of cystic neoplasms compared to pancreatic adenocarcinoma?

A

“Prognosis is significantly better than pancreatic adenocarcinoma.”

72
Q

What imaging modality is preferred for surveillance of cystic pancreatic lesions?

A

“MRI.”

73
Q

What is a characteristic feature of cystadenoma?

A

“Benign

74
Q

How is cystadenoma diagnosed?

A

“CT scan shows a well-circumscribed cystic mass with small septations and central scar with calcifications; ERCP may show dilation of the main duct.”

75
Q

What is the treatment for cystadenoma?

A

“Surgical removal; drainage alone is insufficient.”

76
Q

What is mucinous cystadenoma (MCN) and cystadenocarcinoma?

A

“Pancreatic cystic tumors that can be benign or malignant

77
Q

What diagnostic markers are associated with mucinous cystadenoma?

A

“CT scan showing thick walls

78
Q

What is the treatment for mucinous cystadenoma or cystadenocarcinoma?

A

“Distal pancreatectomy

79
Q

What is Intraductal Papillary Mucinous Neoplasm (IPMN)?

A

“A neoplasm within the pancreatic ducts

80
Q

How is IPMN diagnosed?

A

“ERCP shows mucin from the Ampulla of Vater (fish eye lesion)

81
Q

What is the treatment for IPMN?

A

“Surgical resection based on the length of duct involvement.”

82
Q

What are key characteristics of pancreatic lymphoma?

A

“Large mass located in the head and body of the pancreas.”

83
Q

How is pancreatic lymphoma diagnosed?

A

“EUS-guided biopsy.”

84
Q

What is the treatment for pancreatic lymphoma?

A

“Endoscopic stenting to relieve jaundice

SURGERY (3RD YEAR) (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions