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ARDMS ABD PATHOLOGY > Pancreas Pathology > Flashcards

Pancreas Pathology Flashcards

1
Q

what is acute pancreatitis?

A

inflammation of the pancreas secondary to the leakage of pancreatic enzymes

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2
Q

is acute pancreatitis reversible?

A

YES

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3
Q

what are the 2 most common causes of acute pancreatitis?

A

alcohol abuse
gallstones

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4
Q

the most common location of acute pancreatitis is _____

A

head of the pancreas

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5
Q

ultrasound appearance of acute pancreatitis (4)

A

normal to enlarged
ill-defined borders
peripancreatic fluid
40-60% gallstones

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6
Q

signs/symptoms of acute pancreatitis (3)

A

severe epigastric pain (especially in supine position)
fever
nausea and vomiting

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7
Q

increased lab values of acute pancreatitis (4)

A

amylase
lipase
ALT
WBC

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8
Q

with acute pancreatitis, the first lab value to increase is ____ within 24hrs

A

amylase

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9
Q

with acute pancreatitis, _____ increases within 72hrs

A

lipase

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10
Q

complications of acute pancreatitis (5)

A

pancreatic pseudocyst
phlegmon pancreatitis
pancreatic abscess
hemorrhagic pancreatitis
duodenal obstruction

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11
Q

the most common cystic pancreatic lesion is ____

A

pancreatic pseudocysts

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12
Q

pancreatic pseudocysts are encapsulated _____

A

encapsulated leaked pancreatic enzymes

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13
Q

the most common site of pancreatic pseudocysts is the ____

A

lesser sac

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14
Q

majority of pancreatic pseudocysts resolve within ____

A

4 to 12 weeks

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15
Q

ultrasound appearance of pancreatic pseudocysts (3)

A

anechoic
posterior enhancement
may contain some internal echoes

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16
Q

what is plegmon pancreatitis?

A

peripancreatic fluid collection that results from pancreatitis

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17
Q

another name for plegmon pancreatitis is _____

A

focal pancreatitis

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18
Q

plegmon pancreatitis may proceed to ____ if left untreated

A

necrosis

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19
Q

what is a pancreatic abscess?

A

area filled with pus within the pancreas

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20
Q

pancreatic abscesses have a high mortality rate of ____
_____ if left untreated

A

32 to 65%
100% if left untreated

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21
Q

another name for hemorrhagic pancreatitis is _____

A

necrotizing pancreas

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22
Q

hemorrhagic pancreatitis may occur from (3)

A

alcoholism
surgical trauma
external trauma

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23
Q

chronic pancreatitis causes (4)

A

fibrosis
necrosis
scarring
calcification

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24
Q

patients with ___ and ___ are predisposed to chronic pancreatitis

A

hypercalcemia and hyperlipidemia

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25
ultrasound appearance of chronic pancreatitis (5)
small pancreas heterogenous dilated pancreatic duct calcification portosplenic vein thrombosis
26
signs/symptoms of chronic pancreatitis (4)
persistent epigastric pain anorexia nausea and vomiting constipation
27
what is von hippel-lindau syndrome?
inherited disorder development of tumors and cysts in various organs
28
______ can indicate von hippel-lindau syndrome
hemangioblastomas
29
patients with von hippel-lindau syndrome are at risk of developing ______
pancreatic neuroendocrine tumors
30
what is cystic fibrosis?
autosomal recessive disorder of exocrine glands
31
in _______, abnormal viscous mucus blocks ducts in the pancreas and prevents enzymes from reaching the small intestines
cystic fibrosis
32
ultrasound appearance of cystic fibrosis (4)
hyperechoic pancreas multiple cysts in pancreas cirrhosis with possible PHTN splenomegaly
33
the most common reason for a hyperechoic pancreas in children
cystic fibrosis
34
another name for serous cystadenoma
microcystic adenoma
35
what is serous cystadenoma?
cystic benign tumors < 2cm
36
serous and mucinous cystadenoma are usually seen in the ____
body and tail of the pancreas
37
serous cystadenomas are associated with ____
von hippel-lindau syndrome
38
another name for mucinous adenomas
macrocystic adenomas
39
what is more common, serous or mucinous cystadenomas?
serous cystadenomas
40
mucinous cystadenomas arise from ducts as ____
cystic neoplasms
41
macrocystic adenoma measure ___
> 5cm
42
macrocystic cystadenomas causes
displacement of CBD and pancreatic duct
43
what are islet cell tumors?
endocrine tumors within the islets of langerhans
44
what are the two types of islet cell tumors?
insulinoma and gastrinoma
45
another name for insulinoma
B-cell tumor
46
what is the most common islet cell tumor?
insulinoma
47
insulinoma is common in the ____
tail of the pancreas
48
T/F: insulinoma is most of the time benign
true - 90 to 95% are benign
49
another name for gastrinoma
G-cell tumor
50
gastrinoma is usually in the ____
head of the pancreas and duodenum
51
gastrinoma can produce ____
Zollinger-Ellison syndrome
52
what is Zollinger-Ellison syndrome?
gastric acid hypersecretion that leads to peptic ulcers
53
what is glucagonoma?
rare, pancreatic A-cell tumor
54
glucagonoma is associated with (3)
necrolytic migratory erythema weight loss mild DM
55
pancreatic adenocarcinoma is also known as
pancreatic ductal adenocarcinoma
56
what is the most common primary pancreatic cancer?
pancreatic adenocarcinoma
57
pancreatic adenocarcinoma survival time once diagnosed is ___
3 to 6 months
58
pancreatic adenocarcinoma is usually found in the ____ and leads to ____ and ____
found in the head of the pancreas leads to CBD obstruction and courvoisier GB
59
ultrasound appearance of pancreatic adenocarcinoma (3)
hypoechoic mass in the head double duct sign hydropic GB
60
what is the double duct sign?
dilated CBD and pancreatic duct
61
who are at risk of pancreatic adenocarcinoma? (5)
males smoking family history DM chronic pancreatitis
62
what is the Whipple procedure?
removal of the head of the pancreas, GB, some of the bile ducts, and prox duodenum
63
the Whipple procedure is also called _____
pancreaticoduodenectomy
64
what is pancreatic cystadenocarcinoma?
malignant form of cystadenoma that arises from the lining of the pancreatic duct
65
pancreatic cystadenocarcinoma is usually in the ____
body and tail of the pancreas
66
ultrasound appearance of pancreatic cystadenocarcinoma (3)
multiloculated cystic masses may contain nodules and calcifications dilated pancreatic duct
67
signs/symptoms of pancreatic cystadenoma (5)
asymptomatic initially epigastric pain weight loss palpable mass jaundice
68
a pancreas transplant can be done to treat _____
severe type I diabetes
69
80% of patients who get a pancreas transplant also undergo _____
renal transplant
70
what are the 2 pancreatic transplant techniques?
exocrine bladder drainage exocrine enteric drainage
71
in the exocrine bladder drainage technique, the vascular of the donor pancreas is anastomosed to the recipient's ____
common iliac vessels
72
in exocrine bladder drainage, the donor duodenum is anastomosed to the ____
bladder
73
what are some draw backs of exocrine bladder drainage
dehydration bladder irritation
74
in exocrine enteric drainage, the donor's duodenum is anastomosed to ____
a loop of jejunum
75
what is a "Y" graft?
used in exocrine enteric drainage splenic artery and SMA are connected with the donor's iliac arteries
76
sonographic assessment of a pancreatic transplant includes (3)
evaluation of vascularity evaluation of pancreatic parenchyma search for fluid collections
77
acute rejection of pancreatic transplant includes (3)
hypoechoic pancreas heterogenous parenchyma increase RI
78
chronic rejection of pancreatic transplant looks like: (3)
hyperechoic pancreas atrophic pancreas calcifications
79
complications of pancreatic transplant (6)
arterial stenosis arterial thrombosis graft thrombosis pseudoaneurysm splenic vein thrombosis strictures
80
patients with chronic pancreatitis usually have ___ levels of pancreatic enzymes
decreased
81
most common cause of chronic pancreatitis
alcoholic chronic pancreatitis
82
in children, the most common reason for a pancreatic pseudocyst is
abdominal trauma
83
mucinous cystadenomas are premalignant or malignant lesions with elevated (2)
CEA CA 19-9
84
what is multiple endocrine neoplasia (MEN)?
inherited disorder multiple tumors in endocrine glands tumors may be benign or cancerous
85
MEN syndrome is categorized into
MEN type 1 = Wermer syndrome MEN type 2 = Sipple's syndrome
86
MEN common sites of involvement (5)
parathyroids - hyperparathyroidism pancreatic islet cells - insulinomas/gastronomas pituitary glands - prolactinomas adrenal glands - pheochromocytomas thyroid - medullary thyroid carcinoma

ARDMS ABD PATHOLOGY (13 decks)

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