Pancreas Pathology Flashcards
what clinical test indicates pancreatitis?
elevated serum amylase
what are the main causes of acute pancreatitis?
Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpian bites Hypercalcaeia, hypothermia, hyperlipidaemia ERCP Drugs
why can gallstones cause acute pancreatitis?
they can cause damage to the sphincter of Oddi and bile reflux which causes pancreatic duct epithelial injury.
loss of protective barrier allows autodigestion of pancreatic acinar cells
what are the 6 main complications of acute pancreatitis?
death shock pseudocyst formation abscess formation hypocalcaemia hyperglycaemia
when may chronic pancreatitis develop?
insidiously or following bouts of acute pancreatitis
what are the 5 main causes of chronic pancreatitis?
alcohol cholelithiasis CF hyperparathyroidism familial
what does chronic pancreatitis look like histologically?
- replacement of pancreas by chronic inflammation and scar tissue
- destruction of exocrine acini and islets
what are carcinomas of the pancreas associated with?
smoking, diabetes, familial pancreatitis
what cells within the pancreas produce glucagon?
alpha islet cells
what cells within the pancrease produce insulin?
beta islet cells
what cells within the pancreas produce somatostatin?
delta islet cells
what transporters does insulin add to membranes to increase permeability for glucose?
GLUT4 transporters
if the patient has pancreatitis but there are deranged LFTs what does this show?
cause of pancreatitis is most likely an obstruction of the bile ducts such as a gall stone
what calcium state does pancreatitis cause?
hypocalcaemia
why are ultrasounds used in a patient with acute pancreatitis?
to rule out biliary pancreatitis
which is the diagnostic tool- MRCP or ERCP?
MRCP
what is the function of an ERCP?
an interventional tool to treat common biliary duct stones causing
obstruction
(shouldnt be used for diagnostits)
if the cause of acute pancreatitis is a gall stone what should be done in a couple of months once the condition has settled?
interval cholecystectomy
what are the main symptoms of acute pancreatitis?
epigastric/diffuse abdominal pain pain possibly radiating to back nausea vomiting indigestion abdominal tenderness loss of appetite +/- weight loss temperature jaundice
what blood gases state is usually present with acute pancreatitis?
metabolic acidosis
what are the 3 most important steps with acute pancreatitis?
- give fluids
- give osygen
- give antibiotics
(remove gallstone if obstructive pattern)
why can pancreatitis cause a splenic pseudoaneurysm and haemorrhage?
the pancreatic digestive enzymes start digesting the blood vessels
what is chronic pancreatitis?
progressive and irreversible destruction of pancreatic tissue resulting in permanent loss of exocrine and endoctine function
what is the main type of exocrine pancreatic cancer?
adenocarcinoma
what are the 3 main type of endocrine pancreatic cancers?
gastrinoma
insulinoma
glucagonoma
what are the consequences of a gastrinoma?
produces gastrin causing increased stomach acid causing gastric/duodenal ulcers
what are the consequences of an inulinoma?
produces insulin causing increased glucose uptake from the blood- hypoglycaemia
what are the consequences of a glucagonoma?
produces glucagon to increase blood sugar levels- hyperglcaemia
what is the main purpose of imaging for pancreatitis?
to evaluate complications such as:
necrosis
intra-abdominal collections
vascular complications
