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Pancreas@ Flashcards

1
Q

At what timeframe do acute panc collections become WON or pseudocyst?

A

4 weeks

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2
Q

What stimulates panc secretion?

A

inc permeability of apical Cl/HCO3 channels through cAMP & Calcium

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3
Q

T/F: VIP and secretin stim panc secretion by inc cAMP

A

True

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4
Q

Which substances inc panc secretion by increasing Ca?

A

Gastrin releasing peptide (GRP), subst P

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5
Q

MC presentation of MCN?

A

Unilocular, body or tail, middle aged F

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6
Q

This panc lesion typically multilocular with central stellate calcifications?

A

Serous cystadenoma

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7
Q

Ovarian stroma on path in what?

A

MCN

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8
Q

T/F: All IPMNs have some type of duct communication?

A

True

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9
Q

What is the most potent sti of secretin release by duodenal S cells?

A

Duod pH < 4.5

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10
Q

Which type of FA can stim secretin release?

A

LCFA (oleate)

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11
Q

What is T2 AI panc?

A

idiopathic, duct centric pancreatitis

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12
Q

Which type of AI panc responds better to steroids?

A

Type 2

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13
Q

T/F: Relapses with T2 AI panc are common?

A

False, they are rare

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14
Q

Which type of AI panc has elevated IgG4?

A

Type 1

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15
Q

Path of type 2 AI panc bx?

A

Periductal inflammation and granulocyte epithelial lesions

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16
Q

Which defect causes AD calcific hered pancreatitis?

A

PRSS1 gain of fcn mut

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17
Q

T/F: CFTR is transmitted in AD fashion?

A

False, AR

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18
Q

Which defect causes “tropical panc”?

A

SPINK1

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19
Q

T/F: If suspected infected panc necrosis, abx and conservative mgmt should be tried first.

A

True

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20
Q

What is MC NET with MEN1?

A

Gastrinoma

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21
Q

MEN2a risks

A

Thyroid, adrenal, PT adenomas (PAT)

22
Q

What is pancreatic panniculitis AW?

A

Panc acinar cell carcinoma

23
Q

What is minimum dose of panc enzymes to tx steatorrhea

24
Q

T/F: PPI can be used as a primary tx to tx steatorrhea in CP.

A

False, can be used as adjunct but not primary tx

25
What is Shwachman-Diamond syndrome?
AR dz that can cause panc insufficiency in kids (2nd MC after CF), BM fx w neutropenia --> infxns, short stature
26
What MAL are SDS pts at risk for?
MDS and AML
27
Age groups for T2 and T1 AIP?
T1 ~ 60 yo | T2 ~ 40 yo
28
Which AIP is AW IgG4 dz?
Type 1
29
Granulocyte epithelial lesion
Type 2 AIP
30
T/F: Type 2 AIP not AW extrapanc dz?
True
31
What is T2 AIP recurrence rate after steroids?
< 10%
32
What activates panc enzymes and defect in it is associated with tropical pancreatitis?
Trypsin
33
T/F: Pt swith chronic panc and exocrine insuff are at inc risk of SIBO
True
34
Pt with disabling pain in chronic panc, dilated duct, no further alc use - what is best tx to improve QOL over next 5 yrs?
Peustow
35
List groups of pts that need panc CA screening.
- 2 FDRs - Lynch with 1 FDR - BRCA2 - FAMM syndrome - Peutz-Jeghers syndrome
36
Pts with panc AC are absolute CI to surgical resection if invasion of what vessel?
SMA
37
MCC of hereditary panc is what?
Gain of fcn of cationic trypsinogen gene (PRSS1)
38
MEN1 can lead to what?
HyperPTH, ZES, hypercalcemia, NET (HeNZ)
39
Type 1 vs type 2 AIP histo.
Type 1 - Lymphoplasmacytic sclerosing pancreatitis | Type 2 - Duct centric pancreatitis
40
Rate of relapse after steroids for T1 AIP?
20-60%
41
Which factors inc risk of post ERCP panc?
``` Young age Female Normal LFTs/imaging Multiple cannulation attempts or forceful cannulation Repeated panc injections Precut sphincterotomy Panc sphincterotomy Low case volume endoscopist ```
42
Which med can decrease opioid need in chronic panc?
Pregabalin
43
If AIP leads to obstructive jaundice, consider which type?
Type 2
44
T/F: T1 AIP is AW IBD.
False, type 2
45
Typical IgG4 dz pt presentation affects which organs
Bile duct, panc, salivary glands
46
IgG4 AI panc usually has what panc and panc duct findings?
Narrowed, not enlarged or dilated duct with diffusely enlarged panc
47
What are characteristic findings of glucagonoma?
Rash (necrolytic migratory erythema), high glucose | Dystrophic nails, alopecia, angular chelitis
48
How to dx glucagonoma?
High serum glucagon (>500), CT/MR with findings, consider PET or gad scan
49
How to tx glucagonoma?
Surg if possible, SS analogues can help
50
T/F: PPX anticoag should be done in pts with glucagonoma due to high risk of DVT/PE.
True

Gastro Review (15 decks)

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