pancreas Flashcards

1
Q

which enzyme parallels in elevation to amylase?

A

lipase

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2
Q

when will pancreatitis occur?

A

when pancreatic tissue becomes damaged as a result of increased secretion and blockage of ducts

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3
Q

4 causes of pancreatitis

A

alcoholism, trauma, peptic ulcer disease, biliary tract disease

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4
Q

what are the 5 B’s?

A

booze, blood, bile, bug, birth

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5
Q

what causes acute pancreatitis?

A

release of pancreatic enzymes into the surrounding tissue

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6
Q

what is the most common cause of pancreatitis in the US?

A

biliary tract disease

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7
Q

5 acute pancreatits symptoms

A

nausea, abdominal pain, fever, malaise, jaundice

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8
Q

5 clinical signs of acute pancreatitis

A

pleural effusion, pancreatic ascites, gallstones, lipase and amylase elevation

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9
Q

5 complications of acute pancreatitis

A

pseudocyst, phlegmon, abscess, hemorrhage, duodenal obstruction

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10
Q

sonographic findings of acute pancreatitis

A

swelling/enlargement, hypoechoic or anechoic, borders may be indistinct, compression of IVC

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11
Q

what is hemorrhagic pancreatitis?

A

rapid progression of acute pancreatitis with rupture of vessels and hemorrhage

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12
Q

what may cause focal areas of necrosis?

A

hemorrhagic pancreatitis

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13
Q

5 sonographic findings of hemorrhagic pancreatitis

A

enlarged pancreas, decreased echogenicity, depends on age of hemorrhage, well defined homogeneous mass, areas of necrosis

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14
Q

what is Grey Turner’s sign?

A

discoloration of glands due to necrosis of vessels resulting in hemorrhage

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15
Q

5 sonographic findings of chronic pancreatitis

A

increased echogenicity, decreased size, irregular borders, calcifications, dilated pancreatic duct

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16
Q

what causes a pseudocyst to develop?

A

enzymes that escape and break down tissue somewhere in the abdomen

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17
Q

what is the most common primary neoplasm of the pancreas?

A

adenocarcinoma

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18
Q

T or F? adenocarcinoma is the 4th most common cause of cancer related deaths

A

true

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19
Q

most common site for adenocarcinoma

A

pancreatic head

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20
Q

3 symptoms of adenocarcinoma

A

unexplained weight loss, palpable gallbladder, epigastric pain

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21
Q

how does cystadenoma appear and what may it be confused with?

A

thick walls, septa, cystic appearance

may be confused with pseudocyst

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22
Q

what is the malignant counterpart to cystadenomas?

A

cystadenocarcinoma

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23
Q

2 types of islet cell tumors

A

functioning–do produce hormones

nonfunctioning–do not produce hormones

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24
Q

how does the most common islet cell tumor appear?

A

B-cell tumor appears as numerous small lesions in body and tail

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25
Q

What are acinar cells?

A

the cells of the pancreas that carry out the exocrine function and therefore produce amylase, lipase, and sodium bicarbonate

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26
Q

What is acute pancreatitis?

A

inflammation of the pancreas secondary to the leakage of the pancreatic enzymes from the acinar cells into the parenchyma of the organ

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27
Q

What is the ampulla of Vater?

A

the merging point of the pancreatic duct and CBD just before the sphincter of Oddi, AKA hepatopancreatic ampulla

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28
Q

What is chronic pancreatitis?

A

the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis, scarring, and the development of calcification within the gland

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29
Q

What is chyme?

A

partially digested food

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30
Q

Double-duct sign

A

co-existing enlargement of the cbd and pancreatic duct

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31
Q

What is duct of Santorini?

A

the accessory duct of the pancreas

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32
Q

What is the duct of Wirsung?

A

the main pancreatic duct

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33
Q

What is gastrinoma?

A

an islet cell tumor found within the pancreas

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34
Q

What is insulinoma?

A

an islet cell tumor found within the pancreas

35
Q

What are the isles of Langerhans?

A

small islands of tissue found within the pancreas that produce insulin and glucagon

36
Q

What are islet cell tumors?

A

tumor found within the islet of Langerhans of the pancreas

37
Q

What is the most common form of pancreatic malignancy?

A

pancreatic adenocarcinoma

38
Q

What is pancreatic adenocarcinoma?

A

the most common form of pancreatic malignancy; typically found in the head of the pancreas

39
Q

What is a pancreatic pseudocyst?

A

a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancreas

40
Q

Whipple AKA

A

pancreaticoduodenectomy

41
Q

What is phlegmon?

A

the peripancreatic fluid collection that results from the inflammation of the pancreas

42
Q

what is the sphincter of Oddi?

A

the muscle that controls the emptying of bile and pancreatic juices into the duodenum; AKA hepatopancreatic sphincter

43
Q

What is the uncinate process?

A

posteriormedial extension of the pancreatic head

44
Q

What is von-Hippel-Lindau disease?

A

a hereditary disease that includes the development of cysts within the pancreas and other organs

45
Q

What is Zollinger-Ellison syndrome?

A

syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas

46
Q

The pancreas functions as what two types of glands?

A

exocrine and endocrine

47
Q

Where is the pancreas located?

A

in the epigastrium between the C-loop of the duodenum and the splenic hilum

48
Q

Is the pancreas peritoneal or retroperitoneal?

A

retroperitoneal

49
Q

What is the pancreas primarily?

A

an exocrine gland that aids in digestion

50
Q

What does the amylase do?

A

digests carbs

51
Q

What does lipase do?

A

digests fats

52
Q

What does sodium bicarbonate do?

A

neutralizes stomach acid

53
Q

What do trypsin, chymotrypsin, and carboxpolypeptidase do?

A

digest proteins

54
Q

The endocrine function of the pancreas is performed by what?

A

isles of langerhans

55
Q

The duct of Santorini is a branch from

A

the main pancreatic duct

56
Q

The arterial supply to the head pancreas is from what?

A

gastroduodenal artery

57
Q

The arterial supply to the body and tail of the pancreas is from

A

the splenic artery and SMA

58
Q

What body position may help to visualize the pancreas?

A

left lateral decub

59
Q

The pancreas is typically measured in what dimension?

A

AP dimension in the transverse scan plane

60
Q

What are causes of acute pancreatitis?

A

alcoholism, choledocholithiasis, post endoscopic retrograde cholangiopancreatography, trauma

61
Q

Clinical findings suggesting acute pancreatitis?

A

abdominal and back pain, elevated serum amylase and lipase

62
Q

Describe the pancreas with chronic pancreatitis?

A

small, heterogenous, poorly marginated

63
Q

Clinical findings of chronic pancreatitis

A

asymptomatic, persistent epigastric pain, jaundice, back pain, possible elevation in amylase or lipase

64
Q

Pancreatic adenocarcinoma AKA

A

pancreatic ductal adenocarcinoma

65
Q

A pancreatic cystadenoma with be one of what two things?

A

microcystic (serous) or macrocystic (mucinous)

66
Q

Clinical findings of pancreatic adenocarcinoma?

A
  • elevated amylase and/or lipase
  • loss of appetite
  • weight loss
  • jaundice
  • Courvoisier GB
  • epigastric pain
  • loss of appetite
67
Q

What kind of islet cell tumor is most common?

A

insulinomas

68
Q

Sonographic findings of islet cell tumors:

A
  • hypoechoic mass that may contain calcifications

- visualization is hard because of their small size

69
Q
All of the following are part of the exocrine function of the pancreas except for the:
A. production of lipase
B. production of glucagon
C production of amylase
D. production of sodium bicarb
A

B. production of glucagon

70
Q

What is associated with the development of cysts within the pancreas?

A

Von-Hippel-Lindau disease

71
Q

The most common form of malignancy in the pancreas is

A

adenocarcinoma

72
Q

The most common location of focal pancreatitis is within the

A

head of pancreas

73
Q
All of the following are sonographic findings of chronic pancreatitis except:
A. dilated pancreatic duct
B. calcificatinos within the pancreas
C. pancreatic pseudocyst
D. diffusely hypoechoic pancreas
A

D.diffusely hypoechoic pancreas

74
Q
All of the following are classic clinical features of acute pancreatitis except:
A.Leukocytosis
B. back pain
C. weight gain
D. fever
A

C. weight gain

75
Q

What lab value appears to be most specific for acute pancreatitis

A

lipase

76
Q

One of the most common locations for a pancreatic pseudocyst is within the

A

lesser sac

77
Q

A gastrinoma of the pancreas can produce what?

A

Zollinger-Ellison syndrome

78
Q

The muscle that controls the emptying of bile and pancreatic juices into the duodenum

A

Sphincter of Oddi

79
Q

What is the name for the main pancreatic duct?

A

duct of Wirsung

80
Q

The most common echogenicity of an acutely inflamed pancreas is

A

hypoechoic

81
Q

What is the early sonographic appearance of acute pancreatitis?

A

calcifications within the gland

82
Q

Mucinous cystadenocarcinomas of the pancreas are most often located within which parts of the pancreas

A

head and neck

83
Q

What is the hormone released by the pancreas that encourages the body’s use of glucagon?

A

insulin