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Path - Histo > Pancreas and GB > Flashcards

Pancreas and GB Flashcards

1
Q

what is the pancreas made up of

A

Two different glands mixed together

  • EXOCRINE: bulk — ACINI
  • ENDOCRINE — ISLETS OF LAGERHANS
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2
Q

What do the exocrine glands secrete

A

protease
lipase
amylase

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3
Q

what do endocrine glands secrete

A

insulin
glucagon
somatostatin

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4
Q

what is acute pancreatitis

A

acute inflammation of the pancreas

caused by aberrhant release of pancreatic enzymes

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5
Q

how can causes of acute pancreatitis be split

A
  • Duct obstruction (gallstones, trauma, tumours)
  • Metabolic / toxic (alcohol, drugs, hypercalcaemia, hyperlipidaemia)
  • poor blood supply (shock, hypothermia)
  • infection/inflamm
    etc.

important becuse different causes have different mechanisms of injury

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6
Q

what is the method of injury of duct obstruction to the pancreas

A

obstruction causes reflux of bile up the pancreatic duct > damage to acini

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7
Q

how does alcohol cause pancreatitis

A

spasma/oedema of sphincter of oddi > formation of protein rich pancreatic fluid > obstructs the pancreatic duct

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8
Q

what is the pattern of damage in obstructive pan reatitis

A

PERIDUCTAL - necrosis of acinar cells near the ducts

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9
Q

what is the pattern of damage in ischaemia

A

Perilobular - necrosis at the edges of the lobukles, because they are the furthest away from blood supply

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10
Q

explain the process of SAPONIFICATION in pancreatitis

A

lipases are released from the inflamed pancreas
they cause fat necrosis
calcium binds to the free fatty acids
it forms soaps (YELLOW WHITE FOCI)

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11
Q

what are complications of acute pancreatitis

A

pancreatic: pseudocyst formation, abscess
Systemic: shock, HYPOcalcaemia, HYPOglycaemia

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12
Q

what is a pseudocyst

A

a collection of fluid without an epithelial lining

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13
Q

what is chronic pancreatitis

A

chronic inflammation with parencghymal fibrosis and loss of parenchyma

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14
Q

what are the causes of chronic pancreatitis

A

Metabolic: Alcohol (80%), haemochromatosis
Duct obstruction: gallstones, abnormal anatomy, CF
Other: tumour, AI

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15
Q

describe the injury in chronic pancreatitis

A

parenchymal fibrosis, loss of parenchyma
islets look bigger as acini disappear
duct strictures with calcified stones and secondary dilations

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16
Q

what is the cause of AI pancreatitis

A

IgG4 plasma cells

17
Q

what is histology of AI pancreatitis

A

duct surrounded by lots of IgG4 expressing plasmna cells

18
Q

What are the two types of pancreatic adenocarcinomas

A

Ductal (MOST COMMON)

acinar

19
Q

How are pancreatic neuroendocrine tumours identifiable

A

contain neuroendocrine markeres

  • chromogranin
  • neurosecretory granules
20
Q

what mutation is present pancreatic carcinoma

A

K-ras

21
Q

What is the appearance of a ductal carcinoma

A

gritty, grey

22
Q

what type of tumour is a pancreatic cancer

A

ADENOcardinoma

23
Q

what ae pancreatic neuroendocrine tumours associated with

A

MEN1

24
Q

what are the three types of gallsone

A

MIXED (most common)
cholesterol
pigment

25
Q

what are cholesterol gallstones like on x ray

A

radiolucent = NOT visible on X tay

26
Q

what are pigment gallstones like on x ray

A

radfio opque = VISIBLE

27
Q

what is acute cholecystitis associated with

A

gallstones

28
Q

explain histology of chronic cholecysttis

A

chronic inflamm

fibrosis of gallbladder > THICK waalls

29
Q

what can chronic cholecystitis form

A

may form GALLBLADDER DIVERTICULA

as the gallbladder tried to cntract against the obstruction

30
Q

what does endocrine mean

A

secretes the hormones without ducts, directly into bloodstream

31
Q

What does exocrine mean

A

secretes hormones through ducts

32
Q

What cells are in the islets of lagerhans and what do they secrete

A

alpha: glucagon
beta: insulin
delt: somatostatin

33
Q

what are symptoms of pancreatic carcinoma

A 
WL, anorexia, painless jaundice 
pruritus and staethorroea 
Trusseau's syndrome (recurrent superficial trhombophelbitis) 
Ascitis 
Abdominal mass 
Vichrows node 
Courvousiers sign
34
Q

What surgery can you use for pancreatic carcinoma

A

Whipple proedure

Path - Histo (19 decks)

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