pancreatic

Question 1

basolateral cells of panc have R for

Answer 1

CCK

NT- GRP, Vip, ACH

Question 2

ductules

Answer 2

large volume secretions that bring pH close to normal in order to

• inactivate pepsin
• increase solubility of fatty and bile acids
• block mucosal damage
• optimize pancraetic ad BB enzyeme fx

Question 3

regulators of acinus

Answer 3

endo: CCK, secretin
neuroendocrine: Ach, Grp, vip, subs p

Question 4

regulators of duct

Answer 4

scretin

ach

Question 5

pathway of food

Answer 5

food–>i cells–> cck–>acinus–>digestive enzymes

Question 6

duodenal acidity pathway

Answer 6

–>S cells–>secretin–>duct–>HCO3- and water

Question 7

CCK mech

Answer 7

no receptors in acinus
stimulate vagal afferents–> basal ganglia–>vagal efferents–>pancreatic paraS gang–>ach, vip, grp–>acinar cells–>ezyme–>digest food

Question 8

secretin mceh

Answer 8

h+ secretion–>direct and indirect effects on acinar cells–>HCO3- ad h20

Question 9

enterokiase

Answer 9

on duo enterocytes
claeves trypsinogen–>trypsin
acidic pH inhibits trypsin

Question 10

lack of inh genes

Answer 10

pancreatitis

Question 11

grey turnre sign

Answer 11

ecchymoisis on 1/both flanks

Question 12

cullen sign

Answer 12

ecchymoisis periumilical region

Question 13

serum ca in panc

Answer 13

increase lipase–>desroy fat–>sequeser ca

Question 14

atlanta criteria

Answer 14

abdominal distention consistent w/ acute pancreatitis

increase amylase/lipase >3x normal

+ changes on CT

Question 15

gallstones do not lead o

Answer 15

chronic pancreatitis

Question 16

hereditary ways to get pancreatitis

Answer 16

trypsinogen mutations that make it more resistant to deactivation

def of antitrypsin

cystic fibrosis

familial hypertriglyc

Question 17

early complications of pancreatitis

Answer 17

massive volume losses secondary to third spacing

SiRS

metabolic abnormalities

peripancreatic necrosis

Question 18

late complications of pancreatiti

Answer 18

pseudocysts & abscesses

Question 19

mortality <1 week

Answer 19

secondary to sirs or multiorgan failure

Question 20

mortality >1 week

Answer 20

pancreatic sepsis or multiorgan failure

Question 21

tx mild pancreatitis

Answer 21

iv hydration
rest
remove offending agent

Question 22

tx severe

Answer 22

supportive

ERCP for stones, but risk factor fo acute panc

Question 23

typse of mild pancreatitis

Answer 23

interstitial or edematous pancreatitis

Question 24

types of severe pancreatitis

Answer 24

necrotizing or hemorrhagic pancreatitis

Question 25

pathological hallmark of severe pancreatitis

Answer 25

fatty necrosis

Question 26

saponification

Answer 26

liberated FAs precipitate calcium salts in cytoplasm in svere pancreatitis

Question 27

damage order of pancreatitis

Answer 27

acinar tissue> ducts> islets

Question 28

pseudocyst

Answer 28

walled-off collcetion of fluid or liquified tissue within or adjacent to the pancreas in acute pancreatitis

may include adjacent organs
no epithe. lining

Question 29

abscess

Answer 29

necrotic tissue or a pseudocyst that becomes infected w/ bacteria or fungi from intestine or blood–>liquefied necrotic tissue

Question 30

etio of chronic pancreatitis

Answer 30

alcohol
idiopathic
hereditary
CF
autoimmune
ductal obstruction
tropical

Question 31

hereditary panc pt mutation

Answer 31

cationic trypsinogen gene (PRSS1)– removes a fail safe mech for trypsin inact

Question 32

autoimmune panc on CT

Answer 32

enlarged panc

Question 33

type 1 Aip

Answer 33

igg4

Question 34

pathonmonic for cp

Answer 34

calcified debris in ducts

Question 35

90% of pancreatic cancer

Answer 35

ductal adenocarcinoma

Question 36

RF for panc carcinoma

Answer 36

smoking
chronic panc
DM

Question 37

3 main types of benign tumors

Answer 37

serous cystadenoma
mucinous cysadenoma
intraductal papillary-mucinous adenoma

Question 38

neoplasms w/ moderate dysplasia

Answer 38

intraductal papillary-mucinous neoplasm

mucinous cystic neoplasm