Pancreas Anatomy/Tumors

Question 1

what dermal layer does pancreas come from/

Answer 1

endodermal layer

Question 2

what are the two embryo portions of the pancreas?

Answer 2

ventral and dorsal bud

Question 3

what does the ventral bud lead to?

Answer 3

posterior/inferior head, uncinate process

Question 4

what does the dorsal bud lead to in grown pancreas?

Answer 4

anterior head, body and tail

Question 5

what leads to the main pancreatic duct?

Answer 5

fusion of ventral and dorsal buds

Question 6

what does main pancreatic duct usually drain into?

Answer 6

ampulla of vater

Question 7

what is it called when abnormal fusion of ventral and dorsal buds?

Answer 7

annular pancreas

Question 8

what happens in annular pancreas?

Answer 8

ring of pancreatic tissue encircles the duodenum and can cause obstruction

Question 9

if ventral and dorsal ducts dont fuse what can happen?

Answer 9

pancreas divisum

Question 10

what is seen in pancreas divisum?

Answer 10

two distinct pancreatic ducts…potentially an obstruction

Question 11

what do D cells of the islet of langerhans produce?

Answer 11

somatostatin

Question 12

what is the name for the histo finding in type 1 DM?

Answer 12

insulitis

Question 13

what is insulitis?

Answer 13

lymphocytic infiltrate in and around the islets of langerhans

Question 14

what percent of beta cells are lost when type I DM manifests?

Answer 14

90 %

Question 15

what may be deposited in islets in type 2 DM?

Answer 15

amylin

Question 16

MEN 1 is associated with what gene fxn?

Answer 16

loss of fxn of a tumor suppressor

Question 17

MEN 2a and 2b are associated with what gene fxn?

Answer 17

RET gene…gain of fxn proto oncogene

Question 18

pancreatic neuroendocrine tumors arise from what cell type

Answer 18

pluripotent cells

Question 19

what are the two classifications of pancreatic neuroendocrine tumors?

Answer 19

function or non function

Question 20

what must occur with pancreatic neuroendocrine tumor for it to be considered fxning?

Answer 20

paraneoplastic syndrome (hypersecretion) must be clinically recognized

Question 21

before a tumor becomes a pancreatic neuroendocrine tumor, if it is small and non fxning what is it?

Answer 21

microadenoma

Question 22

once it is over 5 mm in diameter or fxning, what is the tumor considered in the pancreas?

Answer 22

pancreatic neuroendocrine tumor

Question 23

what are three histo types f pancreatic neuoendo tumors?

Answer 23

solid/nested
trabecular
acinar

Question 24

what is characteristic cellular appearance of chromatin in pancreatic neuroendocrine tumors?

Answer 24

salt and pepper appearance

Question 25

what is a diabetic related pancreatic neuroendocrine tumor?

Answer 25

insulinoma

Question 26

what do patients present with when they have insulinoma?

Answer 26

severe hypoglycemia

Question 27

what is insulinoma a tumor of?

Answer 27

beta cells in pancreas

Question 28

are insulinomas usually small or large?

Answer 28

small with no metastaziz

Question 29

what is a gastrinoma

Answer 29

gastrin secreting tumor of G cells in pancreas or duodenum

Question 30

what can gastrinomas cause?

Answer 30

zollinger ellison syndrome

Question 31

what is zollinger ellison syndrome?

Answer 31

gastric hypersecretion...severe peptic ulcerations of stomach duo, jejunum...high gastrin levels

Question 32

what cell proliferates in stomach with gastrinoma?

Answer 32

parietal cells...get gastric folding hypertrophy

Question 33

what is issue in glucagonoma?

Answer 33

neoplasm of alpha cells

Question 34

what is elevates in glucagonoma?

Answer 34

high blood glucose...high levels of glucagon

Question 35

what are three common findings in glucagonoma?

Answer 35

mild diabetes necrolytic migratory erythema anemia

Question 36

which pancreatic neuroendocrine tumor has skin rash?

Answer 36

glucagonoma has a necrolytic migratory erythema

Question 37

what is a somatostatinoma?

Answer 37

neoplasm of delta cells of the pancreas

Question 38

what is role of somatastatin?

Answer 38

inhibits the actions of other neuroendocrine cells

Question 39

what happens to insulin and glucagon levels in a somatostatinoma?

Answer 39

they are suppressed

Question 40

what are symptoms of somatostatinoma?

Answer 40

mild diabetes, gallstones, steatorrhea,

Question 41

what is VIPoma?

Answer 41

vasoactive intestinal polypeptide secreting neoplasm of D1 cells

Question 42

what is normal action of vasoactive intestinal polypeptide?

Answer 42

induces peristalsis

Question 43

what are sx of VIPoma?

Answer 43

explosive and profuse watery diarrhea

Question 44

what are electrolyte changes of VIPoma?

Answer 44

hypokalemia\hypchlorhydria