Pancreas Flashcards
How much enzymic HCO3- rich fluid does the pancreas produce per day
2L
What stimulates the release of enzymic HCO3- rich fluid from the pancreas
Cholecystokinin (CKK)
Secretin
What cell produces secretin and where
S-cells in the duodenum
What does secretin do
Controls gastric acid secretion and buffering with HCO3-
What cell produces CCK and where
I cells in the duodenum
What does CCK do
Causes release of digestive enzymes
Responsible for stimulating digestion of protein and fat
Vasoactive peptide which stimulates the secretion of H2O into the pancreatic system
D1
Criteria for metabolic syndrome
Fasting Hyperglycaemia (>6mmol/l) Hypertension (>140/90mmHg) Microalbuminuria Central obesity (>94cm M, >80cm F) Dyslipidaemia (decrease HDL <1mmol/l AND increased TG >2mmol/l)
Diagnosis of diabetes mellitus
Fasting plasma glucose = >7mmol/l
Random blood glucose = >11.1 mmol/l
Renal complication of diabetes
Glomerulonephritis
Pyelonephritis
What scoring scale used for acute pancreatitis
GLASGOW scale
What score on Glasgow scale means patient should be referred to ITU
Score of 3 or more
I GETSMASHED
Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion venom Hyperlipidaemia ERCP Drugs e.g. thiazides
Most common cause of acute pancreatitis
Gallstones
50% in the U.K. due to this
The most common WORLDWIDE cause of acute pancreatitis
Alcohol
Drugs which can cause acute pancreatitis
furosemide didanosine oestrogens azathioprine thiazide diuretics sulfonamides tetracyclines sulindac mercaptopurine valproic acid L-asparaginase
Histology of acute pancreatitis
Coagulative necrosis
Sensitive test for acute pancreatitis
Serum lipase
Most common cause of chronic pancreatitis
Alcohol
Causes of chronic pancreatitis
Alcoholism
Hereditary eg CF
Autoimmune eg IgG4 sclerosing
Pancreatic duct obstruction eg stones/tumour
Histology of chronic pancreatitis
Fibrosis and loss of exocrine tissue
Duct dilation with secretions
Calcification
Acinar cell carcinoma has positive immunoreactivity for
Lipase
Trypsin
Chymotrypsin
Histopathology of acinar cell carcinoma
Neoplastic epithelial cells with eosinophilic granular cytoplasm
Positive immunoreactivity for lipase, Tripsin and chymotripsin
85% of all pancreatic malignancies
Ductal adenocarcinoma of the pancreas
Common location of ductal adenocarcinoma of the pancreas
Head of the pancreas
Tumour marker of ductal adenocarcinoma of pancreas
CA 19.9 (>70IU/mL)
How are cells arranged in neuroendocrine tumours (islet cell tumours)
Nests or trabeculae with a granular cytoplasm
VIPOMA
Vasoactive intestinal peptide Neuroendocrine tumour (islet cell tumour) Causes diarrhoea
Gastrinoma causes
Zollinger Ellison syndrome which causes recurrent ulceration
Which MEN has marfanoid phenotype
MEN 2B
MEN 1
Parathyroid
Pancreatic endocrine tumour (often Phaeo)
Pituitary adenoma
MEN 2A
Parathyroid
Thyroid
Phaeo
Men2B
Medullary thyroid
Phaeo
Neuroma
Marfanoid phenotype
A pancreatic malformation which which can present with duodenal obstruction in a 1 YO
Annular pancreas
