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ABSITE > Pancreas > Flashcards

Pancreas Flashcards

1
Q

Pancreatic cyst, pigmented histiocytes, low viscosity, high amylase, low CEA, KRAS neg; dx and distribution

A

Pseudocyst, evenly

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2
Q

Pancreatic cyst, acid Schiff+, low viscosity, low amylase, low CEA, KRAS neg; dx and distribution

A

Serous Cystadenoma, evenly

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3
Q

Pancreatic cyst, mucinous, increased viscosity, low amylase, high CEA, KRAS positive; dx and distribution

A

Mucinous Cyst Neoplasm, Tail

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4
Q

Pancreatic cyst, mucinous, high viscosity, high amylase, high CEA, KRAS pos; dx and distribution

A

IPMN, Head

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5
Q

Palpable abdominal mass, 6cm pancreatic head, , weight loss, fevers, elevated LDH, normal CA 19-9; dx and tx

A

Primary pancreatic lymphoma, CHOP or R-CHOP

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6
Q

Indication for IMV ligation during pancreatectomy

A

If it enters the splenic vein to the right of the lesion

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7
Q

Pancreatic duct ≥ 7 mm (normal diameter 3.5 mm) without enlarged pancreatic head; surgical tx and describe

A

Longitudinal pancreatojejunostomy (Puestow procedure)

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8
Q

Pancreatic head/ampullary mass; surgical tx and description

A

Pancreaticoduodenectomy (Whipple procedure)

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9
Q

Enlarged pancreatic head with normal caliber pancreatic duct; surgical tx and description

A

Duodenal sparing pancreatic head resection (Beger procedure)

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10
Q

Dilated pancreatic duct due to obstruction from enlarged pancreatic head; surgical tx and description

A

Lateral pancreatojejunostomy with local pancreatic head resection (Frey procedure)

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11
Q

Approach to infected pancreatic necrosis

A

Step Up

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12
Q

Step Up approach

A

1 - FNA for gram stain/culture + Carbapenem
2 - Perc drainage with upsizing PRN
3 - VARD (video assist retroperitoneal debride)
4 - Necrosectomy (endo vs lap vs open)

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13
Q

Persistent pancreatic pseudocyst not amenable to endo or perc tx

A

Lap or open cystojejunostomy

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14
Q

Infiltrate vascular, lymphatic and perineural space and account for more than 75% of non-endocrine pancreatic cancers

A

Ductal adenocarcinoma

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15
Q

Sudden hematemesis or bloody drain output s/p pancreatic debridement; next step

A

CT angio

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16
Q

Most common functional neuroendocrine tumor and distribution

A

Insulinoma, even

17
Q

Symptomatic annular pancreas, tx

A

Surgical bypass (duo-duo, duo-je, gastro-je)

18
Q

Diameter of pancreatic duct along pancreas

A

4-3-2 rule, 4mm head, 3mm body, 2mm tail

19
Q

Location of splenic artery and vein in respect to pancreas

A

Superiorly and posteriorly to the body/tail

20
Q

Superior modality for staging pancreatic ampullary malignancy

A

EUS

21
Q

Ranson Criteria components

A

Admission:
Age >55, WBC>16, Glucose>200, LDH>350, AST>250
48hrs:
Hct >10%, BUN incr >5, Base deficit >4, Fluid req >6L, PaO2 <60, Ca <8

22
Q

Pancreatic fistula; tx

A

NPO, nasojejunal feeding, correct electrolytes, skincare and close in 4-6wks

23
Q

Definition of high output pancreatic fistula

A

> 200mL/day

24
Q

Pancreas divisum with recurrent pain or pancreatitis, tx

A

Sphincterotomy and tenting of minor papilla

25
Q

Concerned for autoimmune pancreatitis; next step

A

Bx to rule out pancreatic adenocarcinoma

26
Q

Most common PNET, where do they arise

A

Non-functional from islets of Langerhans

27
Q

Unresectable pancreatic cancer definition

A

Mets, extension into hepatoduodenal lig, involvement of major arterial structures or neural structures

28
Q

Ligated in the gastrosplenic ligament during pancreatectomy

A

Short gastrics from the splenic artery

29
Q

Homogenous well-circumscribed fluid collection with hyperdense capsule 4wks after pancreatitis

A

Pancreatic pseudocyst

30
Q

Gallstone pancreatitis with high suspicion for choledocholithiasis; next step

A

ERCP prior to cholecystectomy

31
Q

Best imaging for dx of acute pancreatitis

A

MRCP

32
Q

Subtypes of acute pancreatitis based on Atlanta Classification

A

Interstitial edematous pancreatitis and Necrotizing pancreatitis

33
Q

Severity of acute pancreatitis based upon Atlanta Classification

A

Mild - no organ failure
Moderate - <48hrs organ failure
Severe - >48hrs organ failure

34
Q

Young with unexplained recurrent acute pancreatitis; dx and tx

A

Pancreatic divisum, ERCP

ABSITE (34 decks)

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