Brainscape's Knowledge GenomeTM

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


See full index

Gastrointestinal > Pancreas > Flashcards

Pancreas Flashcards

1
Q

What is the balthazar system?

A

Staging of pancreatitis

a - normal
b - focal/diffuse enlargement
c - intrinsic pancreatic abnl with peripancreatic inflammation
d - fluid collection/phlegmon
e - 2 or more large phlegmonous collections or peripancreatic gas

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

What are the two main appearances of pancreatitis

A

Diffuse gland enlargement

Normal sized gland with peripancreatic fluid

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

What is the diagnostic key for pancreatic parenchymal necrosis?

A

Nonperfusion of a pancreatic segment

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

Which part of the pancreas is most susceptible to necrosis?

A

The body - doesnt have dedicated blood supply

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

What is the natural progression of peripancreatic fluid collections?

A

Most resorp in 2-3 weeks

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

What is a pseudocyst? What does it indicate?

A

A peripancreatic fluid collection with a thick fibrous wall lasting more than 6 weeks

Persistent communication with the pancreatic duct

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

When are pseudocysts usually drained?

A

4cm

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

Irregular fluid collection within a fluid collection surrounding pancreas suggestS?

A

Pseudoaneurysm

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

What causes the colon cutoff sign with regards to pancreatitis?

A

Pancreatic inflammatory fluid occupies the left pararenal space and causes colonic spasm

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

What are the helpful signs that distinguish IPMN and chronic pancreatitis?

A

IPMN will have mainly ductal dilation

Chronic pancreatitis will have parenchymal atrophy

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

What percentage of pancreatic parenchymal loss must occur for pancreatic insufficiency?

A

90%

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

Chain of lakes appearance of the pancreatic ducts is seen with what

A

chronic pancreatitis

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

What are the two types of familial pancreatitis

A

1) familial occurence associated with hyperlipidemia, hyperparathyroidism, CF, cholelithiasis
2) AD inherited syndrome

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

What is hereditary pancreatitis?

A

AD inherited

early bouts of pancreatitis as a kid, increased risk of pancreatic cnacncer

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

Subtype of pancreatitis seen in older men, milder symptoms. What is the marker?

A

Autoimmune pancreatitis

IgG4

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

How are most pancreatic cancers on CT?

A

hypoattenuating mass

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

What US finding is specific for ductal adenocarcinoma?

A

Ductal dilation

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

What are the two important phases in detection of pancreatic tumors?

A

Pancreatic phase (45 seconds) - will have maximal contrast between hypoattenuating mass and parenchyma

Portal venous - detects hepatic mets and lymphadenoapthy

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

How do most pancreatic tumors present on MRI?

A

Hypo in T1 and hyper on T2

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

What does obliteration of the pancreatic - SMA fat plane suggest?

A

Pancreatic mass

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

What are the causes of nonresectibility in pancreatic cancer?

A

Arterial invasion - celiac or SMA
Venous invasion - *limited involvement of SMV and portal can be resected
Regional lymphadenopathy with metastatic tumor
Distant mets

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

Multiple collateral vessels in the upper abdomen in a patient with pancreatic cancer should prompt search for what?

A

splenic/mesenteric vein occlusion

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

What 3 features help distinguish islet cells tumors?

A

Hypervascularity
Lack of vascular encasement
Propensity to calcify

24
Q

What are the common hyperfunctioning islet cell tumors?

A

Insulinoma and gastrinoma

25
Q

Which type of islet cell tumor are worse?

A

Nonfunctioning because they dont have symptoms and can grow to big sizes before detection

26
Q

What is the gastrinoma triad?

A

Location of half of gastrinomas (arise out of pancreas)

Amuplla vater, junction of cystic duct and CBD, and junction of neck and body of pancreas

27
Q

Gastrinomas are associated with what syndrome?

A

MEN I

28
Q

What percentage of gastrinoma are malignant?

A

75%

29
Q

What NM test can detect gastrinoma? Why?

A

Octreotide scintigraphy

High concentration of somatostatin receptiors

30
Q

What is the US difference between primary and metastatic islet cell tumor? Between cavernous hemangioma?

A

PRimary - hypoechoic

Metastatic - hyperechoic with posterior acoustinc shadowing

Hemangioma - no shadowing

31
Q

What is the difference between islet cell tumors associated with MEN and those that arise sporadically?

A

MEN I - tend to be small, multiple, and biologically less aggressive

32
Q

What are the symptoms with glucagonoma

A

necrolytic erythema migrans, diarrhea, diabetes, glossitis

33
Q

What is unique about hepatic mets in hypervascular primary tumors, such as islet cell?

A

Can contain fluid air level

34
Q

Intratumoral calcification with solid and cystic elements in a young african woman

A

Solid and papillary epithelial neoplasm

35
Q

What is the treatment of SPEN

A

total cure with resection

36
Q

What are the unique features of acinar neoplasm?

A

Larger than ductal
Encapsulated
Has metastatic fat necrosis due to systemic release of lipase

37
Q

What tumor causes metastatic fat necrosis

A

Acinar cell carcinoma

38
Q

Most common met to the pancreas?

A

Renal cell

39
Q

What are the two main types of cystic pancreatic masses? Which are benign?

A

Serous - benign

Mucinous - pre/malignant

40
Q

Honeycombed appearance, many (>6) small (

A

Serous “Serous has Several”

41
Q

Few large cysts

A

Mucinous

42
Q

What is the main differential for a mucinous cystadenoma

A

Pseudocyst - will have history of pancreatitis

43
Q

What are malignant features of mucinous neoplasms

A

Thick septation

mural nodules

44
Q

Mucin eminating from the papilla of vater is pathognomonic for what

A

IMPN

45
Q

What is the imaging in IPMN

A

pancreatic ductal dilation with filing defects

46
Q

Identification of a dilated side branch is suggestive of what diagnosis?

A

side branch IPMN

47
Q

What is the size cutoff for resection of side branch IPMN

A

3cm

48
Q

What is the grandma tumor? mother tumor? daughter tumor?

A

Grandma - serous
Mother - “M”ucinous
Daughter - SPEN

49
Q

What are the pancreatic manifestations of VHL?

A

Numerous cysts
Serous cystadenoma
Islet cell tumor

50
Q

Where do pancreatic lacerations most often occur

A

Between the neck and body

51
Q

What is pancreatic divisum?What are the drainage pathways?

A

Failure of the dorsal and ventral portions of the pancreas to fuse

The duct of santorini empties via the accessory papilla

52
Q

What are the two theories of pancreatic annulus forms?

A

Failure of pancreatic atrophy

Ventral portion adheres to duodenum and stretches around it as it rotates into position

53
Q

Calcifications in the pancreas that are not intraductal and without ductal dilation?

A

Sarcoidosis

54
Q

Where are the calcifications with chronic pancreatitis seen

A

Intraductal

55
Q

What does a sausage shaped and with an apparent hypoattenuating halo surrounding an enlarged pancreas suggest?

A

Autoimmune pancreatitis

Gastrointestinal (13 decks)

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