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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
Q

ultrasound appearance of chronic pancreatitis (5)

A

small pancreas
heterogenous
dilated pancreatic duct
calcification
portosplenic vein thrombosis

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26
Q

signs/symptoms of chronic pancreatitis (4)

A

persistent epigastric pain
anorexia
nausea and vomiting
constipation

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27
Q

what is von hippel-lindau syndrome?

A

inherited disorder

development of tumors and cysts in various organs

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28
Q

______ can indicate von hippel-lindau syndrome

A

hemangioblastomas

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29
Q

patients with von hippel-lindau syndrome are at risk of developing ______

A

pancreatic neuroendocrine tumors

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30
Q

what is cystic fibrosis?

A

autosomal recessive disorder of exocrine glands

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31
Q

in _______, abnormal viscous mucus blocks ducts in the pancreas and prevents enzymes from reaching the small intestines

A

cystic fibrosis

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32
Q

ultrasound appearance of cystic fibrosis (4)

A

hyperechoic pancreas
multiple cysts in pancreas
cirrhosis with possible PHTN
splenomegaly

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33
Q

the most common reason for a hyperechoic pancreas in children

A

cystic fibrosis

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34
Q

another name for serous cystadenoma

A

microcystic adenoma

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35
Q

what is serous cystadenoma?

A

cystic benign tumors < 2cm

36
Q

serous and mucinous cystadenoma are usually seen in the ____

A

body and tail of the pancreas

37
Q

serous cystadenomas are associated with ____

A

von hippel-lindau syndrome

38
Q

another name for mucinous adenomas

A

macrocystic adenomas

39
Q

what is more common, serous or mucinous cystadenomas?

A

serous cystadenomas

40
Q

mucinous cystadenomas arise from ducts as ____

A

cystic neoplasms

41
Q

macrocystic adenoma measure ___

A

> 5cm

42
Q

macrocystic cystadenomas causes

A

displacement of CBD and pancreatic duct

43
Q

what are islet cell tumors?

A

endocrine tumors within the islets of langerhans

44
Q

what are the two types of islet cell tumors?

A

insulinoma and gastrinoma

45
Q

another name for insulinoma

A

B-cell tumor

46
Q

what is the most common islet cell tumor?

A

insulinoma

47
Q

insulinoma is common in the ____

A

tail of the pancreas

48
Q

T/F: insulinoma is most of the time benign

A

true - 90 to 95% are benign

49
Q

another name for gastrinoma

A

G-cell tumor

50
Q

gastrinoma is usually in the ____

A

head of the pancreas and duodenum

51
Q

gastrinoma can produce ____

A

Zollinger-Ellison syndrome

52
Q

what is Zollinger-Ellison syndrome?

A

gastric acid hypersecretion that leads to peptic ulcers

53
Q

what is glucagonoma?

A

rare, pancreatic A-cell tumor

54
Q

glucagonoma is associated with (3)

A

necrolytic migratory erythema
weight loss
mild DM

55
Q

pancreatic adenocarcinoma is also known as

A

pancreatic ductal adenocarcinoma

56
Q

what is the most common primary pancreatic cancer?

A

pancreatic adenocarcinoma

57
Q

pancreatic adenocarcinoma survival time once diagnosed is ___

A

3 to 6 months

58
Q

pancreatic adenocarcinoma is usually found in the ____ and leads to ____ and ____

A

found in the head of the pancreas

leads to CBD obstruction and courvoisier GB

59
Q

ultrasound appearance of pancreatic adenocarcinoma (3)

A

hypoechoic mass in the head
double duct sign
hydropic GB

60
Q

what is the double duct sign?

A

dilated CBD and pancreatic duct

61
Q

who are at risk of pancreatic adenocarcinoma? (5)

A

males
smoking
family history
DM
chronic pancreatitis

62
Q

what is the Whipple procedure?

A

removal of the head of the pancreas, GB, some of the bile ducts, and prox duodenum

63
Q

the Whipple procedure is also called _____

A

pancreaticoduodenectomy

64
Q

what is pancreatic cystadenocarcinoma?

A

malignant form of cystadenoma that arises from the lining of the pancreatic duct

65
Q

pancreatic cystadenocarcinoma is usually in the ____

A

body and tail of the pancreas

66
Q

ultrasound appearance of pancreatic cystadenocarcinoma (3)

A

multiloculated cystic masses
may contain nodules and calcifications
dilated pancreatic duct

67
Q

signs/symptoms of pancreatic cystadenoma (5)

A

asymptomatic initially
epigastric pain
weight loss
palpable mass
jaundice

68
Q

a pancreas transplant can be done to treat _____

A

severe type I diabetes

69
Q

80% of patients who get a pancreas transplant also undergo _____

A

renal transplant

70
Q

what are the 2 pancreatic transplant techniques?

A

exocrine bladder drainage
exocrine enteric drainage

71
Q

in the exocrine bladder drainage technique, the vascular of the donor pancreas is anastomosed to the recipient’s ____

A

common iliac vessels

72
Q

in exocrine bladder drainage, the donor duodenum is anastomosed to the ____

A

bladder

73
Q

what are some draw backs of exocrine bladder drainage

A

dehydration
bladder irritation

74
Q

in exocrine enteric drainage, the donor’s duodenum is anastomosed to ____

A

a loop of jejunum

75
Q

what is a “Y” graft?

A

used in exocrine enteric drainage

splenic artery and SMA are connected with the donor’s iliac arteries

76
Q

sonographic assessment of a pancreatic transplant includes (3)

A

evaluation of vascularity
evaluation of pancreatic parenchyma
search for fluid collections

77
Q

acute rejection of pancreatic transplant includes (3)

A

hypoechoic pancreas
heterogenous parenchyma
increase RI

78
Q

chronic rejection of pancreatic transplant looks like: (3)

A

hyperechoic pancreas
atrophic pancreas
calcifications

79
Q

complications of pancreatic transplant (6)

A

arterial stenosis
arterial thrombosis
graft thrombosis
pseudoaneurysm
splenic vein thrombosis
strictures

80
Q

patients with chronic pancreatitis usually have ___ levels of pancreatic enzymes

A

decreased

81
Q

most common cause of chronic pancreatitis

A

alcoholic chronic pancreatitis

82
Q

in children, the most common reason for a pancreatic pseudocyst is

A

abdominal trauma

83
Q

mucinous cystadenomas are premalignant or malignant lesions with elevated (2)

A

CEA
CA 19-9

84
Q

what is multiple endocrine neoplasia (MEN)?

A

inherited disorder
multiple tumors in endocrine glands
tumors may be benign or cancerous

85
Q

MEN syndrome is categorized into

A

MEN type 1 = Wermer syndrome
MEN type 2 = Sipple’s syndrome

86
Q

MEN common sites of involvement (5)

A

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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