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Surgery > Pancreas > Flashcards

Pancreas Flashcards

1
Q

The most common congenital anomaly of the pancreas.

A

Pancreas divisum

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2
Q

Duct of wirsung arises from what bud

A

Small ventral bud

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3
Q

Uncinate process arises from what bud

A

Small ventral bud

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4
Q

Duct of santorini arises from what bud

A

Dorsal bud

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5
Q

Pancreatic body and tail and superior portion of the head arise from what bud

A

Dorsal bud

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6
Q

Treatment of pancreatic divisum.

A

sphincterotomy and cholecystectomy

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7
Q

Treatment of annular pancreas.

A

duodenojejunostomy

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8
Q

Failure of the ventral bud to rotate

A

Annular pancreas

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9
Q

Blood supply to the head of pancreas

A

SMA and Gastroduodenal artery

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10
Q

Blood supply to body of pancreas

A

Splenic artery

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11
Q

Superior venous drainage of pancreas drains into? Inferior drains into?

A

PV; IMV

Body and tail - splenic vein

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12
Q

Pancreas secretes how much pancreatic fluid daily

A

500-1500 mL

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13
Q

Flank ecchymosis [Grey-Turner’s sign] and periumbilical ecchymosis [Cullen’s sign] are seen in

A

Acute pancreatitis

Retroperitoneal bleeding

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14
Q

Confirmatory diagnosis for acute pancreatitis

A

Contrast abdominal CT

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15
Q

Contrast-enhanced abdominal CT finding: Peripancreatic fat stranding, fluid collections, and non-enhancing pancreatic parenchyma with gas

A

Acute pancreatitis

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16
Q

A way to predict morbidity and mortality in patients admitted with acute pancreatitis

A

Ranson’s criteria

And APACHE II

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17
Q

Prophylactic antibiotic for necrotizing pancreatitis

A

Imipenem

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18
Q

CT scan reveal a dilated, calcified pancreatic duct with areas of stenosis (ie, “chain of lakes” appearance).

A

Chronic pancreatitis

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19
Q

The gold standard for the diagnosis of chronic pancreatitis

A

ERCP

irregular main duct, ductal dilation, and duct strictures.

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20
Q

Surgical procedure of choice for chronic pancreatitis with duct of normal diamete

A

Pancreaticoduodenectomy (Whipple)

21
Q

Surgical procedure of choice for chronic pancreatitis dilated duct

A

Longitudinal pancreaticojejunostomy (Puestow)

22
Q

Surgical procedure of choice for chronic pancreatitis with distal disease

A

Distal pancreatectomy

23
Q

Surgical procedure of choice for chronic pancreatitis with small duct with diffuse disease

A

Total pancreatectomy with autotransplantation of islet cells

24
Q

Peripancreatic fluid collections with a nonepithelialized capsule.

A

Pseudocyst

Complication of chronic pancreatitis

Persistent abdominal pain and early satiety

25
Q

Imaging of choice for pancreatic pseudocyst

A

MRI

26
Q

Pancreatic pseudocysts are most commonly associated with

A

alcoholic pancreatitis

27
Q

Characterized by mucin production, dilation of the pancreatic duct, and communication with the main pancreatic duct.

A

Intraductal papillary mucinous neoplasms (IPMNs)

Head of pancreas

28
Q

Cystic neoplasm of pancreas that are commonly found in middle-aged females and in the body or tail of the pancreas and characterized by an ovarian-like stroma and a lack of ductal communication.

A

Mucinouscystic neoplasms (MCNs)

Distal pancreatectomy

29
Q

Classic presentation of pancreatic ductal adenocarcinoma

A

Painless jaundice

30
Q

Palpable gallbladder: what sign?

A

Courvosier’s sign

31
Q

Palpable periumbilical metastatic disease

A

Sister Mary Joseph’s node

32
Q

Migratory thrombophlebitis

A

Trousseau’s sign

33
Q

Palpable metastases on rectal examination

A

Blumer’s shelf

34
Q

Elevated marker in pancreatic ductal adenocarcinoma

A

CA 19-9 and CEA

35
Q

ERCP finding of double duct sign with two strictures

A

Pancreatic ductal adenocarcinoma

CBD and pancreatic duct dilatation

36
Q

Chemoradiotherapeutic regimens for pancreatic cancer

A

gemcitabine, 5-fluorouracil

37
Q

ERCP finding of double duct sign with one stricture

A

Ampullary cancer

38
Q

Tumors of what part of the pancreas are usually not detected at an early stage and are usually unresectable at time of diagnosis?

A

body and tail

39
Q

5 year survival rate of pancreatic cancer

A

10-20%

40
Q

Whipple’s triad is seen in

A

Insulinoma

41
Q

Migratory necrolytic erythema, anemia, DM, protein malnutrition, hypercoagulability and stomatitis are symptoms of

A

Glucagonoma

42
Q

Watery diarrhea, hypokalemia, achlorrhydia and hypercalcemia are SSx of

A

VIPoma or Verner-Morrison syndrome

WDHA syndrome

43
Q

Preoperative medication for insulinoma to prevent hypoglycemia

A

Diazoxide

44
Q

Treatment for small insulinoma (

A

Enucleation

45
Q

Boundaries of the gastrinoma triangle

A

(1) Cystic duct
(2) Junction of the second and third portions of the duodenum
(3) Junction of the neck and body of the pancreas

46
Q

A 50-year-old male with a history of chronic pancreatitis presents with bleeding gastric varices. What is the most likely cause? Curative treatment?

A

Most likely diagnosis is splenic vein thrombosis. As patient is bleeding, treat with splenectomy.

47
Q

What is the most common location of an insulinoma? Gastrinoma? Glucagonoma? Somatostatinoma?

A

Insulinoma: Evenly distributed throughout the pancreas.
Gastrinoma: Gastrinoma triangle.
Glucagonoma: Pancreatic tail.
Somatostatinoma: head

48
Q

A 65-year-old man presents with painless jaundice, and you suspect PDAC. What is the most sensitive radiographic modality to diagnosis PDAC?

A

Endoscopic ultrasound

Surgery (10 decks)

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