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GI > Pancreas > Flashcards

Pancreas Flashcards

1
Q

A patient presenting with painless jaundice is always suspicious of ?

A

Malignancy
Pancreatic head CA
Cholangiocarcinoma

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2
Q

Which carcinoma of the pancreas is most common ?

A

Ductal adenocarcinoma

Pancreas head

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3
Q

Name the mutation found in 95% of patients with pancreas CA

A

KRAS2

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4
Q

Name 4 risk factors for developing pancreas CA

A

Obesity
Smoking
Alcohol
Chronic pancreatitis

Chemicals in dry cleaning / metal work
Diabetes mellitus 2 
Liver cirrhosis 
H pylori 
Familial pancreatitis 
Vom hippel Lindau 
Neurofirbomatosis 1 
Lynch syndrome
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5
Q

What might a patient with pancreas CA present with ?

A 
Asymptomatic initially
Painless obstructive jaundice ( if head )
Belt- like epigastric pain radiating to back ( if body or tail )
Steatorrhea 
Pale stools
Dark Urine 
Weight loss
Superficial thrombophlebitis
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6
Q

Which tumour markus might be raised in a tumour of the pancreas ?

A

CEA

C10-0

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7
Q

What’s the double duct sign?

A

Seen in pancreas CA

Imaging shows dilated bike and pancreatic duct

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8
Q

What is courvoisier sign?

A

Enlarged gallbladder + painless jaundice

Seen in pancreas CA , esp of head

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9
Q

Name 2 pancreatic endocrine tumours

A

= tumour of islet cells

  • insulinoma
  • Gastrinom
  • VIPomas
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10
Q

Name 3 complications of pancreas CA. What’s the prognosis ?

A

Liver metastasis
DIC
Stenosis : gastric outlet or cholestasis
Necrolytic erythema

Poor, 5 year survival 3% , mean survival <6 months

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11
Q

Causes of acute pancreatitis

A 
Idiopathic
Gallstones 
Ethanol 
Trauma 
steroids
Mumps
Autoimmune
Scorpion venom
Hyperlipidaema/hypertension/hypercalcaemia 
ERCP !! Post investigation
Drugs : thiazides
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12
Q

How might a patient with acute pancreatitis present with ?

A

Sudden
Onset epigastric pain ( can radiate to back if retroperitoneum involved)
Bilious vomiting

Fever, tachycardia , jaundice
Shock, paralytic ileus

Cullen sign
Grey turner sign

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13
Q

Name 2 signs specific to acute pancreatitis

A

Cullen sign - periumbilical echymoses

Grey turners sign
flank echymoses

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14
Q

Name two blood tests you need to perform in pancreatitis

A

Amylase

Lipase

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15
Q

Which scales predicts severity in pancreatitis ?

A

Glasgow scale

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16
Q

How to manage acute pancreatitis

A 
Nil by mouth + NG tube
Analgesia
Oxygen
Insulin sliding scale
Correct hypocalcaemia 
Antibiotics : imipenem, meropenem

Surgery if very severe to remove necrosis

17
Q

What’s the main cause of chronic pancreatitis ?

A

Alcohol

CF
Congenital
Recurrent acute pancreatitis

18
Q

Name 2 specific signs of chronic pancreatitis ?

A

Epigastric tenderness

Erythema ab igne ( hyperpigmentation of warm areas )

GI (7 decks)

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