Pancreas Pathology

Question 1

what clinical test indicates pancreatitis?

Answer 1

elevated serum amylase

Question 2

what are the main causes of acute pancreatitis?

Answer 2

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpian bites
Hypercalcaeia, hypothermia, hyperlipidaemia
ERCP
Drugs

Question 3

why can gallstones cause acute pancreatitis?

Answer 3

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

Question 4

what are the 6 main complications of acute pancreatitis?

Answer 4

death
shock
pseudocyst formation
abscess formation
hypocalcaemia
hyperglycaemia

Question 5

when may chronic pancreatitis develop?

Answer 5

insidiously or following bouts of acute pancreatitis

Question 6

what are the 5 main causes of chronic pancreatitis?

Answer 6

alcohol
cholelithiasis
CF
hyperparathyroidism
familial

Question 7

what does chronic pancreatitis look like histologically?

Answer 7

• replacement of pancreas by chronic inflammation and scar tissue
• destruction of exocrine acini and islets

Question 8

what are carcinomas of the pancreas associated with?

Answer 8

smoking, diabetes, familial pancreatitis

Question 9

what cells within the pancreas produce glucagon?

Answer 9

alpha islet cells

Question 10

what cells within the pancrease produce insulin?

Answer 10

beta islet cells

Question 11

what cells within the pancreas produce somatostatin?

Answer 11

delta islet cells

Question 12

what transporters does insulin add to membranes to increase permeability for glucose?

Answer 12

GLUT4 transporters

Question 13

if the patient has pancreatitis but there are deranged LFTs what does this show?

Answer 13

cause of pancreatitis is most likely an obstruction of the bile ducts such as a gall stone

Question 14

what calcium state does pancreatitis cause?

Answer 14

hypocalcaemia

Question 15

why are ultrasounds used in a patient with acute pancreatitis?

Answer 15

to rule out biliary pancreatitis

Question 16

which is the diagnostic tool- MRCP or ERCP?

Answer 16

MRCP

Question 17

what is the function of an ERCP?

Answer 17

an interventional tool to treat common biliary duct stones causing
obstruction
(shouldnt be used for diagnostits)

Question 18

if the cause of acute pancreatitis is a gall stone what should be done in a couple of months once the condition has settled?

Answer 18

interval cholecystectomy

Question 19

what are the main symptoms of acute pancreatitis?

Answer 19

epigastric/diffuse abdominal pain
pain possibly radiating to back
nausea
vomiting
indigestion
abdominal tenderness
loss of appetite +/- weight loss
temperature
jaundice

Question 20

what blood gases state is usually present with acute pancreatitis?

Answer 20

metabolic acidosis

Question 21

what are the 3 most important steps with acute pancreatitis?

Answer 21

1. give fluids
2. give osygen
3. give antibiotics
   (remove gallstone if obstructive pattern)

Question 22

why can pancreatitis cause a splenic pseudoaneurysm and haemorrhage?

Answer 22

the pancreatic digestive enzymes start digesting the blood vessels

Question 23

what is chronic pancreatitis?

Answer 23

progressive and irreversible destruction of pancreatic tissue resulting in permanent loss of exocrine and endoctine function

Question 24

what is the main type of exocrine pancreatic cancer?

Answer 24

adenocarcinoma

Question 25

what are the 3 main type of endocrine pancreatic cancers?

Answer 25

gastrinoma
insulinoma
glucagonoma

Question 26

what are the consequences of a gastrinoma?

Answer 26

produces gastrin causing increased stomach acid causing gastric/duodenal ulcers

Question 27

what are the consequences of an inulinoma?

Answer 27

produces insulin causing increased glucose uptake from the blood- hypoglycaemia

Question 28

what are the consequences of a glucagonoma?

Answer 28

produces glucagon to increase blood sugar levels- hyperglcaemia

Question 29

what is the main purpose of imaging for pancreatitis?

Answer 29

to evaluate complications such as:
necrosis
intra-abdominal collections
vascular complications