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Digestive > Pancreas Pathology > Flashcards

Pancreas Pathology Flashcards

1
Q

Is the pancreas Retroperitoneal or Intra?

A

Retro

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2
Q

2 main causes of pancreatitis

A

metabolic - alcohol, mechanical - gall stones

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3
Q

pathology of pancreatitis

A

autodigestion by pancreatic enzymes, cell injury response mediated by cytokines

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4
Q

consequences of enzyme release in pancreatitis

A
  1. proteases - acini, ducts islets
  2. Lipases - fat necrosis (pancrease and other sites)
  3. Elastatses - blood vessel destruction - lead to interstitail hemorage
  4. Cell injury response - inflamation, odema, imparied blood flow, ishcaemia
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5
Q

what triggers acute pancreatitis event

A
  1. obstruction - gallstones, and ductal concretions present in alcoholics. Increase ductal pressure, accumulate enzyme rich fluid, fat necrosis, promotes odema and local inflamation, odema compromises blood flow,
  2. Diect injury to acinar cells - viruses, drugs, trauma, ischaemia - release of enzymes
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6
Q

clinical features of acute pancreatitis

A

acute abdominal pain (epigastric), nausea vomiting, fever , abdominal tenderness

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7
Q

diagnosis of acute pancreatitis

A

high white cell coun, elevated serum amylase, ct scan - odema, necrosis, may need laparotomy

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8
Q

management of acute pancreatitis

A

IV fluid, dont eat - no stimulating pancrease, analgesia, close monitoring

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9
Q

Causes of chronic pancreatitis

A

repeated bouts of pancreatic inflamation, loss of function and replacement by fibrous tissue

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10
Q

Pathology of chronic panreatitis

A

fibrotic organ, atrophy of exocrine compoenent (not so much endocrine), mild chronic inflammatory infiltrate , intraductal protein plugs and calcified concretions

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11
Q

clinical features of chronic pancreatitis

A
  • repeatated attacks of abdominal pain (can be after alcohol)
  • more persistant pain
  • if ongoing - loss of exocrine funciton (malabsorption), psudocysts, rarely diabetes mellitus
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12
Q

diagnosis of chronic pancreatitis

A

serum amlylase, CT imaging

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13
Q

Pancreatic carcinoma - who normally gets it and cause

A

males, older, poor survival, poor prognosis. Smoking risk, maybe also alcohol and caffiene

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14
Q

pathology of pancreatic carcinoma

A

most occurs in head, then invades ampulla and then bilary obstruction occurs

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15
Q

Clincal features of pancreatic carcinoma

A

obstructive jaundice, pain, weight loss, pancreatitis, usually seen on CT scan

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16
Q

Cholelithiasis - what are the 2 types of gall stones made of

A

cholesterol stones, pigment stones

17
Q

How do cholesterol gall stones form?

A

bile supersaturated with cholesterol, and this favors crystal formaiton, then if they remain in gallbladder stones will form

18
Q

Risk factors for cholelithiasis

A

Incidence rises for increasing age in women, estrogenic influences, obesity, rapid wiehgt loss favor stone formaiton , history of glal stones

19
Q

Risk factors for pigment stones

A

chronic haemolytic syndromes, bacterial infection of bilary tree, pigment stones are predominant in non-western populations due to infections and parasites

20
Q

clinical consequences of gallstones

A

only about 1-3% symptomatic, cholecystitis - acute/chronic, bilary colic (bile duct obstructed - pain), complications of above e.g cholangitis - bacterial infeciton

21
Q

Acute cholecystitis

A

mostly due to gallstones, obstruction of the neck of gallbladder or cystic duct

22
Q

clinical features cholecystitis

A

RUQ - abdominal pain and tenderness (often after fatty meals), fever, neutrophil leucocytosis, raised bilirubin, ALP, GGT if stone in common bile duct

23
Q

Chronic cholecystitis

A

multiple episodes of acute inflamation, generaly due to gall stones,

24
Q

management of chornic cholecystitts

A
  • Initaly - iv and pain releif, long tmer - cholecystecotmy but need inflamation settled down first
25
Q

choledocholithiasis

A

presence of stones in bilary tree, cmplications - bilary obstruction (coliky abdonminal pain, obstructive jaundice), pancreatitis, cholangitits

26
Q

3 things that can go wrong with the pancreas

A

Cystic fibrosis
Acute and chronic pancreatitis (inflammation of pancreas, acinar cell injury)
Carcinoma of the pancreas

27
Q

Carcinoma of gallbladder

A
  • older people
  • mainly adenocarcinoma
  • most go to liver
  • low survival
28
Q

Carcinoma of extrahepatic ducr

A
  • uncommon
  • adenocarcinoma
  • slowely obstruct biled duct - get jaundice, pale stools, weight loss, nausea
29
Q 
Cholelithiasis
Cholecystitis
Choledocholithiasis
Cholangitis
Cholestasis
A

Cholelithiasis - gall stones
Cholecystitis - inflamed gall bladder
Choledocholithiasis - gall stone in common bile duct
Cholangitis - bacterial infection due to obstruction
Cholestasis - decrease bile flow, due to obstruction of intra or extrahepatic ducts

Digestive (15 decks)

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