Pancreasđź‘˝ Flashcards
The percentage ofpatients who will have an occurrence of a replaced right hepatic artery is
A. 1-2%
B. 5-10%
c. 15-20%
D. 20-25%
C
The most common complication ofchronic pancreatitis is
A. Pseudocysts
B. Duct strictures and/or stones
C. Pancreatic necrosis
D. Duodenal obstruction
A pseudocyst
Insulinomas assc with multiple endocrine neoplasia syndrome
A. Do not usually require resection
B. Sporadic in nature
C. Lower rate of recurrence
D. More likely to be malignant
B sporadic in nature
A pancreatic cystic neoplasms that is <3 em, has atypical cells present, and has a solid component
A. Requires a repeat CTscanin3to6months
B. RequiresarepeatCTscanin1year
C. Requirescontinuedobservation
D. Requires resection
D. Requires resection read compre abscite pancreas question 4 diagram
According to Ranson criteria a 67-year-old female patient suspected of acute pancreatitis presenting to the OR with sudden onset of severe abdominal pain, a serum aspartate transaminase (AST) >250 U/dL, a white blood cell (WBC) >16,000/mm3, and a blood glucose >200 mg/dL would receive a disease classification of
A. Predicted severe
B. Predicted mild, uncomplicated
C. Predicted moderate
D. Amortalityof10%
A. Predicted severe. Read compre absite q5
Which of the following is the most common presenting symptom in patients with a somatostatinoma?
A. Cholelithiasis
B. Constipation
C. Hypoglycemia
D. Hypocalcemia
A. Cholelithiasis
The etiology associated with chronic calcific pancreatitis is
A. Hyperparathyroidism
B. Hyperlipidemia
C. Alcoholabuse
D. All ofthe above
D
patients undergoing endoscopic retrograde cholangio pancreatography (ERCP) for diagnosis and staging of chronic pancreatitis, the population most at risk of devel oping procedure- induced pancreatitis is
A. One with calculus disease
B. Onewithintraductallesions
C. Onewithsphincterof Oddi dysfunction
D. One with a high percentage of parenchymal calcification
C. One with sphincter of oddi dysfunction
And a history of post op ercp pancreatitis
Treatment of a 1 cm GASTRINOMA in the wall of the duodenum is best accomplished by
A. Enucleation
B. Full-thickness resection
C. Duodenectomy
D. Whippleprocedure
B full thickness resection
50% metastasizes to lymph nodes and are therefore malignant
The ERCP finding that is virtually diagnostic of intra ductal papillary mucinous neoplasms (IPMNs) is
A. A fish-eye lesion
B. Calcification
C. Beaded or chain-of lakes appearanceoftheduct
D. Cysts that resemble serous cystadenomas
A fish eye lesion
Pain from chronic pancreatitis can be caused by
A. Ductal hypertension
B. Parenchymal disease
C. Obstructive pancreatopathy
D. Allow the above
D. AOTA
A px undergoing Frey procedure to relieve pain from obstructive pancreatopathy is found to have 85% parenchymal fibrosis. The percentage of pain relief the patient is likely to experience is
A. 50%
B. 10%
c. 100%
D. 60%
C 100%
The only therapy shown to prevent the progression chronic pancreatitis is
A.Pancreatic duct decompression
B. Major resection
C. Transduodenal sphincteroplasty
D. Roux-en-Y pancreaticojejunostomy
A. Pancreatic duct decompression
The part of the pancreas re cessful resolution of PAIN
chronic pancreatitis is
A. The head
B. The body
C. The neck
D. The tail
A. The head
Especially the central portion= long term relief
- In pylorus-preserving resections of the pancreas, the technique with the lowest rate of pancreatic leakage is
A. Stent
B. Glue
C. Octreoride
D. AOTA
D. Aota
The prognosis factor that does NOT decrease survival rates in patients with gastrinomas is
A. Liver metastases
B. Absence of MEN 1
C. Lymph node metastases
D. Primary tumor located Outside Of Passaro triangle
C. Lymph node metastes. Remember! Presence of gastrinoma=50% metastasizes to the lymph nodes= resect all as it is malignant
The origin of the inferior pancreaticoduodenal artery is the
A. Gastroduodenal artery
B. Superior mesenteric artery
C. Superior pancreaticoduodenal artery
D. Common hepatic artery
B. Superior mesenteric a
The A
of PP (pancreatic polypeptide) cells is found in the
A. Head of the pancreas
C. Tail of the pancreas
B. Body of the pancreas
D. None of the above—they are equally distributed across the pancreas
A head of the pancreas
Head and uncinate process (ventral)—->High PP, LOW ALPHA cells
Tail (dorsal) and body—-> HIGH ALPHA, LOW PP CELLS
Insulin secretion is stimulated by
A. Lysine
B. Somatostatin
C. Amylin
D. Alpha adrenergic stimulation
A. Lysine
Others: mnemonics: FALL”
FFA
Arginine
Leucine
Lysine
Which of the following pancreatic enzymes is secreted in an active form? A. Amylase
B. Chymotrypsinogen
C. Tyrpsinogen
D. Pepsin
A. Amylase
Only 1
Sympathetic stimulation of the pancreas results in
A. Stimulation of endocrine and exocrine secretion
B. Inhibition of endocrine and exocrine secretion
C. Stimulation of endocrine and inhibition of exocrine secretion
D. Inhibition of endocrine and stimulation of exocrine secretion
B. inhibit both!
Somatostatin-28, one of the two active forms of somatostatin present in the human body, selectively binds to
A. SSTR1
B. SSTR3
C. SSTR5
D. None of the above
C. SSTR5
The most common gene mutation found in pancreatic cancer is
A. HER2/neu
B. K-ras
C. p53
D. Smad 4
B. KRAS -90%
Pancreatic delta cells produce
A. Somatostatin
B. Ghrelin
C. PP
D. Glucagon
A. SOmatostatin
Insulin- beta
Glucagon- alpha
Somatostatin- D cells
PP- PP cell
Amylin- beta
Pancreastatin- beta
A. Lipases
B. Amylase
C. Proteases
D. All of the above
D.AOTA
Which of the following is the primary stimulus for secretion of bicarbonate by the pancreas?
A. CCK
B. Gastrin
C. Acetylcholine
D. Secretin
D. Secretin
Major.
CCK, GHRELIN, ACH- lesser extent
The veins of the HEAD of the pancreas drain into the
A. Ant. Surface of the portal vein
B. Posterolateral surface portal vein
C. Right renal vein
D. Inferior vena cava
B. Posterolateral surface lf the portal vein
Which of the following is NOT a cause of elevated gastrin ?
A. Proton pump inhibitors
B. Gastric outlet obstruction
C. Chronic pancreatitis
D. Pernicious anemia
C. Chronic pancreatitis
Whichof the ff should be ordered in a px with gastrinoma
A serum vit d
B. Serum calcium
C. Serum B12 level
D. Stool occult
B. Serum calcium
To rule out MEN1
Men 1 rarely normalizes serum gastin or even improve survival with resection of gastrinoma
Preservation of the pylorus during the Whipple procedure may
A. Increase the incidence of marginal ulcers
C. Impair gastric emptying
B. Maintain normal gastric hormone release
D. Improve quality of life
B. Maintain normal gastric hormone release
Which of the following drugs has been shown to improve outcome in patients with mild
pancreatitis?
A. H2 blockers
B. Somatostatin
C. Glucagon
D. None of the above
D nota
Supportive thru restriction of food and fluids only
Which of the following procedures is the best treatment for a01.5-cm insulinoma located in the mid pancreas
A enucleation
B. Wedge resection
C distal pancreatomy
D. Duodenal sparing total pancreatectomy
A Enucleation
If >2 cm, letter C with pancreaticoduodenectomy
The most common type of pancreatic cancer is
A. Ductal AdenoCa
B Adenosquamous CA
C ACINAR cell carcinoma
D. SCCA
A. Ductal adenoCA
Pancreas divisum occurs as a result of
A. Pancreatitis
B. Carcinoma of the pancreas
C.Trauma
D. Abnormal fusion of the pancreatic ducts
D. Abnormal fusion of the p ducts
Which of the ff is the initial med used to treat pain in px w chronic pancreatitis
A. Enteric coated pancreatic enzyme prep
B N o n – e n t e r i c - c o a t e d -p a n c r e a t i c e n z y m e p r e p a r a t i o n s
C. Octreotide
D. Somatostatin
B. Non enteric coated pancreatic enzyme prep
The median survival following pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer is approximately
A 9 mo
B 2 yrs
C 4 yrs
D 8 yrs
B. 2 yrs