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Surgery final (Sabiston) > Pancreatic AC > Flashcards

Pancreatic AC Flashcards

1
Q

Pancreatic AC is of an ___ source - the ___ of the pancreatic ducts.

A

exocrine

epithelium

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2
Q 
The different types of exocrine pancreatic cancer are:
PDAC= \_\_\_ (80%)
IPMN= \_\_\_
\_\_\_
\_\_\_
A

pancreatic ductal AC
intraductal papillary mucinous neoplasm
acinar cells Ca
islet cells

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3
Q 
Islet cell pancreatic cancer is responsible for: (5)
\_\_\_
\_\_\_
\_\_\_
\_\_\_
\_\_\_
A 
insulinoma
gastrinoma 
VIPoma
glucagonoma
somatostatinoma
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4
Q

Pancreatic AC is more common in ___ ___ with mean age of ___

A

black
men
72

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5
Q 
Risk factors include: (8)
\_\_\_ (X3)
\_\_\_ age
\_\_ and \_\_
chronic \_\_\_
link to \_\_ and \_\_\_
high \_\_ diet 
past history of \_\_
A 
smoking
old
obesity & DM
pancreatitis
CF & ataxia-telangiectasia
fat
gastrectomy
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6
Q 
What are the main genetic syndromes associated with pancreatic cancer? (6)
\_\_\_ (40%)
\_\_\_ X132
\_\_ /\_\_ X4, X8
\_\_\_ X10
\_\_\_
\_\_\_ X30
A 
familial pancreatitis
Peutz Jeghers
FAP/HNPCC
BRCA 2
Li Fraumeni 
CF
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7
Q

70% of pancreatic tumors are found at the __ of the pancreas, 30% at the __ and ___

A

head
body
tail

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8
Q

What are the most common symptoms of pancreatic cancer in the head of the pancreas?
___ 75%
___ loss 50%
___ pain radiating to the back 40%
__/__/__
___ sign (gallbladder is palpable but not sensitive)

A 
jaundice
weight 
epigastric
nausea/vomiting/pruritus
Courvoisier sign
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9
Q

___ syndrome is the most common sign for tumors at the __ of the pancreas

A

Trousseau (vessel inflammation due to blood clot)

head

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10
Q

The most sensitive marker for pancreatic cancer is CA __ with sensitivity and specificity of ___%

A

CA 19-9

80

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11
Q

Pancreatic cancer diagnosis is made primarily with ___. Now days ___ is becoming more prominent

A

tri phase CT

PET CT

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12
Q

EUS with FNA is indicated before starting ___ (eg __) therapy

A

chemo

neoadjuvant

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13
Q

Pancreatic cancer staging (tumor):
T1- __ to the pancreas, __ cm
T3- __ to the pancreas, but does not involve important __ (may involve __)
T4- __ to the pancreas, involve important ___. Is considered to be ___

A 
limited
2
unlimited
arteries
veins
unlimited 
arteries
inoperable
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14
Q

Pancreatic cancer staging (nodes/metastasis):
N0- ___ nodes
N1- ___ nodes

M0- __
M1- __ (most commonly to the __ and __)

A 
no
yes
no
yes
liver
lungs
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15
Q

What are the inoperable pancreatic tumors according to staging?
T_=stage_=involvement of main __
M_=stage_=__

A

T4=stage3=arteries

M1=stage4=metastasis

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16
Q

What are the main arteries to notice when talking about pancreatic cancer? (2)

A

SMA

celiac

17
Q

What are the 3 classes of pancreatic tumors when considering surgery?

A

definitely operable
borderline
definitely inoperable

18
Q

Definitely operable pancreatic tumors are tumors found only in the ___, without any important __ involvement, and a fatty layer surrounding the ___

A

pancreas
venous
arteries

19
Q

What are the main veins to notice when talking about pancreatic cancer? (2)

A

SMV

portal vein

20
Q

Inoperable pancreatic tumors are stage -, __, positive __ outside the field of operation, involvement of main __ vessels

A

3-4
ascites
lymph nodes
blood (beside the splenic)

21
Q

Only ___% of pancreatic cancer cases are considered __

A

20

operable

22
Q

When the pancreatic tumor is found in the ___ of the pancreas, the go to surgery is __

A

head

Whipple

23
Q

Whipple has 3 stages: dissecting the __ of the pancreas together with the (4). Followed by removing the __, and finally performing ___.

A 
head
CBD
gallbladder
duodenum
antrum 
lymph nodes
reconstruction
24
Q

What does Whipple reconstruction involves?

A

pancreatojejunostomy
hepaticojejunostomy
gastrojejunostomy

25
Q 
What are the possible p/o Whipple risks (4)
delayed gastric \_\_\_ 18%
pancreatic \_\_\_/\_\_\_leakage 
\_\_\_/abdominal \_\_
pancreatic \_\_\_
A

delayed gastric emptying
pancreatic fistulas/anastomosis leakage
SSI/abdominal abscess
pancreatic insufficiency

26
Q

The classical treatment chemotherapy is ___ with ___ protocol (4) __/__

A

neoadjuvant
FOLFRINOX
5fu/ oxaliplatin/ irinotecan/ leucovorin

Surgery final (Sabiston) (54 decks)

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