Pancreas Flashcards

1
Q

What is pancreas agenesis?

A

Absence of pancreas

Often with other malformations that make incompatible with life

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2
Q

What is the most common congenital pancreatic anomaly?

A

Panrcreas divisum

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3
Q

What happens with pancreas divisum?

A

Dorsal and ventral ducts don’t fuse…the bulk of the pancreas drains through the dorsal pancreatic duct

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4
Q

What is it called when pancreatic tissue wraps around the second part of the duodenum?

A

Annular pancreas…usually a non-issue

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5
Q

What effect does acute pancreatitis have on fatty tissue and the pancreatic parenchyma?

A

Leakage of pancreatic enzymes injures the fat and parenchyma

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6
Q

What are the microscopic and gross findings of acute hemorrhagic necrotizing pancreatitis?

A
Hemorrhage
Fat necrosis (soft, chalky white areas)
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7
Q

What are the microscopic and gross findings of long-standing chronic pancreatitis?

A

Irreversible destruction
Fibrosis (TGF-b and PDGF)
Sprinkling of chronic inflammatory cells

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8
Q

How does chronic pancreatitis cause pancreatic insufficiency?

A

Repeated injury –> irreversible loss of acinar cell mass –> pancreatic insufficiency

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9
Q

On examination of pancreatitis; gross findings include a mass, and microscopic findings include lymphocytic sclerosing. What type of pancreatitis is it?

A

Type I autoimmune pancreatitis (IgG-related disease)

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10
Q

What is the treatment for IgG-related diseases like Type I autoimmune pancreatitis?

A

Glucocorticoid therapy

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11
Q

It is determined that a pancreatic cyst is lined by fibrin and granulation tissue instead of epithelium. What is this cyst most accurately called? What are the two most common causes?

A

Pancreatic pseudocyst

Caused by acute pancreatitis or trauma

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12
Q

Lab examination of a pancreatic cyst shows small cysts with clear, thin, straw-colored fluid surrounded by glycogen-rich cuboidal cells. What kind of cyst is it? Why did the patient come in? Who is the most likely patient? Is this cyst likely cancerous?

A

Serous (microcystic) cystadenoma…fluid filled and small…name makes sense

Presents with abdominal pain…most often in old people

Benign

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13
Q

A middle aged woman is found to have cysts on her pancreas that are large, multiloculated, and filled with mucin. What kind of cysts? Where are these cysts most likely located on the pancreas? Is this cancerous?

A

Mucinous cystadenoma…filled with mucin…name makes sense

Slow growing mass in tail or body of pancreas

Cystadenoma is benign…cystadenocarcinoma is malignant

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14
Q

An older patient presents with a growth in his neoplasm that communicates with a dilated pancreatic duct system and lacks “ovarian type” stroma. What is the name of the growth? Is it cancerous?

A

Intraductal papillary mucinous neoplasm

Can be benign or malignant

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15
Q

Where does pancreatic cancer rank on the list of causes of cancer deaths?

A

Pancreatic cancer is the FOURTH leading cause of cancer deaths

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16
Q

What is the most common type of pancreatic carcinoma?

A

Ductal adenocarcinoma is the MOST common form of pancreatic cancer

17
Q

What are some risk factors to developing ductal adenocarcinoma?

A
Smoking
Obesity/inactivity
Diabetes
Chronic pancreatitis
Family history
Specific inherited predispositions 
Hereditary pancreatitis
Older than 60
18
Q

If resection of pancreatitis is curative, how come so few pancreatic tumors are resected?

A

Tumors have to be stage I or II to be resected…most pancreatic tumors don’t present until stage III or IV

19
Q

How is pancreatic carcinoma diagnosed?

A

Imaging followed by biopsy

20
Q

What is done in the Whipple procedure for the treatment of pancreatic cancer?

A

Removal of part of the stomach, part of the pancreas, and most (all?) of the duodenum…new connections are then made with the remaining parts

21
Q

After a Whipple procedure, what is the order of things entering the duodenum/jejunum?

A

Pancreas (very beginning…mouth)
Bile duct (shortly after)
Stomach (after a while)

22
Q

Who is most likely to develop a solid-pseudopapillary tumor?

A

Young women

23
Q

Who is most likely to develop a pancreatoblastoma?

A

Pre-teens/teenagers

24
Q

What type of pancreatic tumor is well-circumscribed?

A

Pancreatic neuroendocrine tumors are well-circumscribed

25
Q

What hormones can be produced by pancreatic neuroendocrine tumors?

A

Insulin –> hypoglycemia
Gastrin –> peptic ulcer (Z-E syndrome)
Glucagon –> hyperglycemia, rash, anemia
Somatostatin –> diabetes, gallstones, steatorrhea, hypochlorhydria
VIP –> watery diarrhea, hypokalemia, achlorhydria