Pancreas

Question 1

pancreatic adenocarcinoma

Answer 1

mean patient age is 55

typically pancreatic head

average survival time is 4-6 months

symptoms: abd/back pain, jaundice, weight loss

Question 2

branches off the celiac axis

Answer 2

left gastric artery, common hepatic, and splenic artery

Question 3

accumulation of pancreatic fluid and necrotic debris confinded by the retroperitoneum

Answer 3

pancreatic pseudocysts

contain high amounts of amylase, lipase, and trypsin

Question 4

pancreatic duct measurement

Answer 4

<2mm

Question 5

which portion of the duodenum does the ampulla of vater open into

Answer 5

2nd portion at the major papilla

Question 6

complication of acute pancreatitis

Answer 6

psuedocyst, abscess, pancreatic necrosis, hemorrhage, venous thrombosis, pseudoaneurysm

Question 7

what planes are the 4 portion of the duodenum seen

Answer 7

1st and 3rd are trans

2nd and 4th are long

Question 8

pancreatic duct dilatation is typically due to what?

Answer 8

stones within wirsungs duct from chronic pancreatitis or a stone at the ampulla of vater

Question 9

associated findings of pancreatic adenocarcinoma

Answer 9

courvoisier’s GB

bile duct dilatation

dilated pancreatic duct

liver mets

ascites

lymphadenopathy

pseudocyst formation

elevated conjugated bilirubin, alk phospatase, GGT, amylase, lipase

Question 10

most common islet tumor, usually benign, hypoglycemic

Answer 10

insulinoma

Question 11

exocrine function

Answer 11

to secrete trypsin, lipase, and amylase for digestion

Question 12

structures that are in contact with the pancreatic head

Answer 12

IVC

CBD

ampulla of vater

GDA

c loop of duodenum

Question 13

SMA and SMV relationship to pancreas

Answer 13

posterior to neck and anterior to uncinate

anterior to the 3rd portion of the duodenum

SMV is to the rt of the SMA

Question 14

sono findings of pancreatic adenocarcinoma

Answer 14

solid hypoechoic mass

Question 15

most common reason for pancreatic pseudocyst in children

Answer 15

abd trauma

Question 16

most common cause of chronic pancreatitis

Answer 16

alcoholic chronic pancreatitis

serum amylase and lipase elevation only during acute attacks

Question 17

benign, cluster of grape-like cysts and external lobulation. associated with von Hippel-Lindau disease

Answer 17

pancreatic serous cystadenoma

Question 18

inflammatory disease producing temporary changes, enlarged hypoechoic gland

Answer 18

acute pancreatitis

Question 19

posterior medial boarder of pancreas

Answer 19

splenic vein

Question 20

aorta, celiac, and SMA relation

Answer 20

ao posterior to body

celiac axis arises superior border of pancreas

SMA inferior border of pancreas

Question 21

an inflammatory mass formed by edema and leakage of pancreatic enzymes

Answer 21

pancreatic phlegmon

forms as a complication of acute pancreatitis

Question 22

course of GDA

Answer 22

travels posterior to the first portion of the duodenum then anterior to pancreas head

divides into right gastroepiploic and superior pancreaticoduodenal artery

Question 23

ultrasound findings in pancreas associated with cystic fibrosis

Answer 23

hyperechoic pancreas

cland atrophy

fibrosis and fatty replacement

cysts due to ductal obstruction

meconium ileus is a common associated condition

Question 24

multiple endocrine neoplasia (MEN)

Answer 24

inherited endocrine disorder

MEN type 1 and type 2

parathyroids, pancreatic islets cells, pituitary, adrenal, thyroid

Question 25

proper hepatic artery direction

Answer 25

travels superiorly toward the liver anterior to the portal vein and left bile duct right gastric is a branch off

Question 26

which rises later and persists for longer amylase or lipase

Answer 26

lipase

Question 27

congenital anomaly where ventral pancreas encircles the second portion of the duodenum

Answer 27

annular pancreas

Question 28

failure of dorsal and ventral pancreatic ductal systems to fuse during embryonic development

Answer 28

pancreas divisum

Question 29

travels posterior to the 1st portion of duodenum and pancreas head to lie right of the main pancreatic duct

Answer 29

CBD

Question 30

common causes of pancreatic pseudocysts

Answer 30

acute pancreatitis chronic pancreatitis pancreatic trauma pancreatic ductal obstruction pancreatic neoplasms

Question 31

head of the pancreas relationship to the IVC and duodenum

Answer 31

head anterior to IVC head medial to duodenum

Question 32

large multicystic mass with numerous septations and debris. uncommon, potentially malignant

Answer 32

mucinous cystic neoplasms

Question 33

sonographic findings of chronic pancreatitis

Answer 33

small and echogenic gland calcification pancreatic duct dilatation pseudocyst formation bile duct dilatation portal vein thrombosis

Question 34

most common causes of acute pancreatitis

Answer 34

gallstones 40% alcohol abuse 35%

Question 35

pancreatic cysts

Answer 35

true pancreatic cysts are rare associated with adult polycystic kidney disease and von Hippel-Lindau syndrome

Question 36

where does the accessory pancreatic duct open into the duodenum

Answer 36

2nd portion at the minor papilla 2 cm prox to the ampulla of vater

Question 37

irreversible destruction due to repeated bouts of pancreatic inflammation

Answer 37

chronic pancreatitis

Question 38

inferior mesenteric vein

Answer 38

drains left lower quadrant sigmoid and descending colon drains directly into the splenic vein

Question 39

common hepatic divides into

Answer 39

proper hepatic and gastroduodenal arteries

Question 40

most common site of pseudocyst

Answer 40

lesser peritoneal sac

Question 41

superior border of body and tail

Answer 41

splenic artery

Question 42

2nd most common islet cell tumor, gastric acid hypersecretion, ulcer, frequently malignant

Answer 42

gastrinoma | (zollinger-ellison syndrome)

Question 43

relational anatomy to body and tail

Answer 43

posterior wall of stomach overlies anterior border of tail and body tail is located anterior and medial to splenic hilum

Question 44

endocrine function

Answer 44

non-ductal, to secrete insulin via islets of langerhans alpha, beta, delta

Question 45

exocrine gland disorder resulting in viscous secretions causing pancreatic dysfunction

Answer 45

cystic fibrosis

Question 46

what percentage of the population has complete regression of the duct of santorini

Answer 46

50%

Question 47

relation of CBD and GDA to pancreatic head

Answer 47

CBD posterior/lateral to head GDA anterior/lateral to head

Question 48

pancreas location

Answer 48

within anterior pararenal space of retroperitoneum