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Basic Human Pathology 2 > Pancreas > Flashcards

Pancreas Flashcards

1
Q

what is the hooked portion of the pancreas called and why is it important

A

uncinate process - important because it becomes a surgical margin

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2
Q

where is the pancreas located

A

retroperitoneal

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3
Q

does the pancreas have a capsule

A

no

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4
Q

define endocrine

A

substances are secreted directly into bloodstream

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5
Q

define exocrine

A

substances are secreted into a ductal system

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6
Q

what is the endocrine portion (1-2%) of the pancreas

A

islets of langerhans which include beta cells, alpha cells, delta cells, and PP cells

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7
Q

what is the exocrine portion of the pancreas composed of

A

acinar cells and ducts

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8
Q

what are acinar cells made of

A

zymogen granules

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9
Q

what do zymogen granules of acinar cells do

A

make digestive, pancreatic enzymes

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10
Q

what do the small pancreatic ducts release

A

bicarbonate fluid

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11
Q

what do the large pancreatic ducts release

A

mucin

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12
Q

what do the pancreatic ducts express

A

cystic fibrosis transmembrane conductance regulator (CFTR)

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13
Q

what is the most common congenital anomaly of the pancreas

A

pancreas divisum

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14
Q

what is pancreas divisum

A

congenital anomaly where the duct of wirsung does not connect to the duct of Santorini
most patients are asymptomatic but it can cause pancreatitis

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15
Q

what is annular pancreas

A

congenital anomaly where there is a band-like ring of pancreatic tissue that encircles the second portion of the duodenum
can lead to a duodenal obstruction

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16
Q

what is pancreatic heterotropia

A

congenital anomaly where there is pancreatic tissue in other areas of the abdominal cavity
ex. stomach

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17
Q

what is a pancreatic cyst

A

small, unilocular cyst made of a single layer of flattened cuboidal cells in a pancreatic duct
usually contains clear, serous fluid

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18
Q

what is an important fact about a pancreatic cyst

A

it does not communicate with the ductal system

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19
Q

what are the two conditions associated with pancreatic cysts

A

polycystic kidney disease
von Hippel-Lindau Syndrome

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20
Q

what three things will you see macroscopically in the pancreas of someone with cystic fibrosis

A

fibrosis
fat replacement
cyst formation

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21
Q

what will you see microscopically in the pancreas of someone with cystic fibrosis

A

dilation of acini with accumulation of eosinophilic secretions

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22
Q

what is hereditary hemochromatosis

A

recessive disease that is classified as the inappropriate increased iron absorption from the duodenum and small intestine
leads to a brown appearing pancreas macroscopically

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23
Q

what is the most common cause of acute pancreatitis

A

impaction of stones within the common bile duct (choledocholithiasis)

24
Q

what is the second most common cause of acute pancreatitis

A

excessive alcohol intake

25
Q

what is the macroscopic presentation of acute pancreatitis

A

fat necrosis

26
Q

where is the most common location for adenocarcinoma of the pancreas

A

head

27
Q

which two viruses can cause acute pancreatitis

A

mumps
coxsackievirus

28
Q

which procedure can cause acute pancreatitis

A

endoscopy procedures like ERCP

29
Q

what is fat saponification

A

fatty acids combine with calcium to form calcium soaps

30
Q

what is the most common cause of chronic pancreatitis

A

long term alcohol abuse in middle aged men

31
Q

what is the macroscopic presentation of chronic pancreatitis

A

parenchymal fibrosis with proteinaceous plugs

32
Q

what are three ways in which alcohol affects the pancreas

A

increases contraction of sphincter of Oddi
causes protein plugs
generate free radicals in the acini

33
Q

what is a pancreatic pseudocyst

A

the bodies attempt to wall off areas of necrotic pancreatic tissue
leads to a cystic structure made of fibrosis
the cyst is often filled with pancreatic enzymes

34
Q

what is autoimmune pancreatitis

A

form of chronic pancreatitis that is a IgG4 related disease
leads to sclerosing cholangitis (inflammation of the bile duct)

35
Q

onion-skin is seen in which condition

A

primary sclerosing cholangitis

36
Q

what are the three types of non-cystic exocrine pancreatic neoplasms

A

pancreatic intraepithelial neoplasia
ductal adenocarcinoma
acinar cell carcinoma

37
Q

what are the three types of cystic exocrine pancreatic neoplasms

A

serous cystic
mucinous cystic
intraductal papillairy

38
Q

what is a pancreatic intraepithelial neoplasia (PanIN)

A

precursor, “in-situ” lesion of pancreatic ductal adenocarcinoma
classified by WHO in PanIN-1-3

39
Q

which cancer has one of the highest mortality rates of all malignancies

A

ductal adenocarcinoma

40
Q

85-90% of all pancreatic neoplasms are what

A

ductal adenocarcinoma

41
Q

what are some risk factors to ductal adenocarcinoma

A

old age
smoking
chronic pancreatitis
diabetes mellitus
genetic defects

42
Q

what is the most frequent altered oncogene in pancreatic cancer

A

KRAS

43
Q

what is the most frequently inactivated tumor suppressor gene

A

P16

44
Q

what is acinar cell carcinoma

A

lobulated, encapsulated mass with a flesh consistency

45
Q

what are the two categories of WHO classifications for serous cystic neoplasms

A

serous cystadenoma (benign)
serous cystadenocarcinoma (malignant)

46
Q

what is a microcystic serous cystadenoma

A

benign cyst that is very sponge/honeycomb like
made of many smaller cysts filled with small watery fluid
has a central, fibrous scar

47
Q

what is a macrocystic serous cystadenoma

A

benign, unilocular cyst that only has one layer of cuboidal cells

48
Q

what are the two types of mucin producing cystic neoplasms

A

mucinous cystic neoplasm (MCN)
intraductal papillary mucinous neoplasm (IPMN)

49
Q

who is most likely to get a mucinous cystic neoplasia

A

women around 50 years of age

50
Q

what is the difference between a mucinous cystic neoplasm and a intraductal papillary mucinous neoplasm

A

the mucinous cystic neoplasm has no communication with the ductal system
the intraductal papillary mucinous neoplasm communicates with the ductal system

51
Q

what is the most important diagnostic feature of a mucinous cystic neoplasm

A

ovarian-type stroma beneath the epithelium

52
Q

what is the most common neoplastic cyst of the pancreas

A

intraductal papillary neoplasia

53
Q

what is the microscopic presentation of a intraductal papillary neoplasm

A

papillary architecture with mucin producing cells

54
Q

what is the most common type of pancreatic neuroendocrine tumor

A

insulinoma

55
Q

what is the most common pancreatic neoplasm in young children

A

pancreatoblastoma

56
Q

pancreatoblastomas are associated with which condition

A

beckwith-weidemann syndrome

57
Q

what could you see under the microscope in the pancreas of a patient with diabetes mellitus

A

amyloid deposits

Basic Human Pathology 2 (14 decks)

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