Pancreas-Exam 2 Flashcards
What is the left limb of the pancreas supplied by? (blood vessel)
Splenic a.
What is the body/right limb of the pancreas supplied by?
Caudal pancreaticoduodenal a. (branch of cranial mesenteric a.)
What duct drains the R lobe and enters the duodenum at the major duodenal papilla w/ bile duct?
Pancreatic duct- drains R lobe
What is the difference in the duct system in cats vs. dogs?
Cats don’t have an accessory duct
What drains in to the minor DP in dogs?
Accessory pancreatic duct- drains L lobe
What do the following pancreatic cells produce?
A, B, D, F/P
A: glucagon
B: insulin
D: somatostatin
F/P: pancreatic polypeptide
T/F: Pancreatitis is a sx disease?
FALSE- common but not sx
What biopsy method is used for the pancreas?
Guillotine technique
What is indicated for a pancreatic tumor removal?
Partial pancreatectomy
What are the best tools for dissecting lobules?
Hemoclips or bipolar cautery
If the remaining ducts are patent in the pancreas-what percentage can be removed?
80%
What is the most common complication associated with partial pancreatectomy?
Pancreatitis
What happens if pancreatic drainage is completely obstructed?
Exocrine pancreatic insufficiency
What is the tx of exocrine pancreatic insufficiency?
Pancreatic enzyme supplementation & low fat/highly digestible food
What occurs when over 80-90% of the pancreas is removed?
Endocrine pancreatic insufficiency
What is the tx for endocrine pancreatic insufficiency?
Insulin
What can occur if you accidentally ligate vessels that are around the R lobe of the pancreas?
Devitalization of duodenum
What is the instrument of choice for pancreatic sx?
Ligasure
Why are pancreatic pseudocysts not true cysts?
Lack epithelial wall
T/F: Pancreatic pseudocysts are often incidental findings
TRE
What is the test of choice for pancreatic pseudocyst?
US- most sensitive
T/F: You cannot differentiate pseudocyst from abscess on US
TRUE
What is the first line tx for pancreatic pseudocyst?
Percutaneous aspiration- especially if aclinical
What is the tx of choice for cure of pseudocysts?
Omentilization
What is typically secondary to acute bouts of pancreatitis?
Pancreatic abscess
T/F: Most pancreatic abscesses are sterile
TRUE
What ab data supports pancreatic abscesses?
Hyperbilirubinemia/elevated LEZ due to EHBO- inflammation of pancreas causing duodenal papilla of CBD to swell shut
What is the best method of sx management for pancreatic abscesses?
Omentalization
What is a rare but highly malignant tumor in dogs that arises from APUD cells
Gastrinoma
APUD: amine precursor uptake decarboxylase cells
What is the zollinger-ellison syndrome?
Syndrome of gastric acid, hypersecretion, gastrointestinal ulceration & non-B cell pancreatic tumors
What is a diagnostic factor for gastrinoma?
High serum gastrin levles
What is a malignant and locally invasive tumor in the pancreas?
Exocrine pancreatic adenocarcinoma
What is the prognosis of a patient with exocrine pancreatic adenocarcinoma?
Poor
What is insulinoma?
B-cells of islets of Langerhans–> secrete insulin despite hypoglycemia
What % of insulinoma is malignant?
90%
What are the components of the whipples triad?
CS associated w/ hypoglycemia
Fasting blood glucose concentration of 40 mg/dL or ower
Relief of neurological signs w/ feeding or glucose administration
What is a def dx for insulinoma?
Fasting insulin glucose ratio
Insulin HIGH despide hypoglycemia
What are the normal fasting serum levels?
5-26 mg/dL
Affected animals > 70 mg/dL
What are some medical management methods for insulinoma
Small frquent meals (high protein, complex carbs)
Glucocorticoid therapy
Oral hyperglycemic agents- DIazoxide
What is the gold standard sx tx for insulinoma?
Partial pancreatectomy
What are the MST for the following insulinoma situations:
No sx
Sx
Sx + medical therapy
No sx: 196 days
Sx: 785 days
Sx + medical management: 1316 days
What is the main medication used in patients with insulinoma when combined with sx?
Pred
What is the difference of MST for the following stages
I
II
III
I: 785 days
II: 547 days
III: 217 days
