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GI/Liver > Pancreatic-Biliary Disease > Flashcards

Pancreatic-Biliary Disease Flashcards

1
Q

How do gallstones present?

A

Increasing frequency of attacks of right upper quadrant pain which is crmpay in nature and usually occurs after meals
No jaundice or fever, unless stones are stuck in the bile duct

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2
Q

What type of gallstones are most common?

A

Mixed stones

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3
Q

Most gallstones can be seen on x-ray. T/F?

A

False - only 10% of stones have sufficient calcium to be seen on x-ray

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4
Q

What imaging modality is used to look for gallstones?

A

Ultrasound

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5
Q

What is the presentation of gallstones in the bile duct?

A

Acute and severe RUQ pain and obstructive jaundice

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6
Q

What are the expected LFT results for obstructive jaundice as seen in gallstones in the bile duct?

A

Raised ALP and bilirubin

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7
Q

How can gallstones in the bile duct be investigated?

A

MRCP
Endoscopic ultrasound
Operative cholangiogram

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8
Q

How are gallstones in the bile duct treated?

A

ERCP, laparoscopic cholestectomy and bile duct clearance

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9
Q

What is the presentation of acute pancreatitis?

A

Severe acute upper abdominal pain with fever, light-headedness and vomiting

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10
Q

What features will be seen on blood results in acute pancreatitis?

A

Leucocytosis

Raised serum amylase

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11
Q

What are the most common causes of acute pancreatitis?

A

Alcohol

Gallstones

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12
Q

Other than alcohol excess and gallstones, what are the possible causes of acute pancreatitis?

A

ERCP
hypercalcaemia
Drugs (e.g. azathioprine)
Mumps

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13
Q

What are the potential complications of acute pancreatitis?

A

Pancreatic abscesses
Infective pancreatic necrosis
Avascular haemorrhage pancreatitis

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14
Q

How are pancreatic abscesses treated?

A

Drainage or necrosectomy plus antibiotics

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15
Q

What is an intraductal mutinous neoplasm of the pancreas?

A

A desuplatic, papillary lining secreting mucin which is in continuity with the main pancreatic duct or a side duct

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16
Q

What are the features of a mutinous cystic neoplasm of the pancreas?

A

Mutinous lining

Ovarian type stroma

17
Q

A serous cyst adenoma of the pancreas is always malignant. T/F?

A

False - it is almost always benign

18
Q

What are the signs and symptoms of pancreatic cancer?

A 
Painless obstructive jaundice
New onset diabetes
Weight loss
Hepatomegaly
Fatigue/lethargy
Abdo pain due to pancreatic insufficiency or nerve invasion
19
Q

How is pancreatic cancer usually diagnosed?

A

CT

20
Q

Pancreatic cancer has a poor prognosis. T/F?

A

True

21
Q

What is involved in supportive care for pancreatic cancer?

A

Insertion of a stent via ERCP to manage jaundice

22
Q

What test is required if chemotherapy is being considered for the treatment of pancreatic cancer?

A

Brushings to pathologically confirm cancer

23
Q

What surgical procedure can be used to treat tumours of the head of the pancreas?

A

Whipple’s resection

24
Q

Most patients with pancreatic cancer are suitable candidates for surgery with Whipple’s. resection. T/F?

A

False

25
Q

What neoadjuvant therapy to surgery can be used in the treatment of pancreatic cancer?

A

Folfrinox chemotherapy

26
Q

What is the most common cancer type of the pancreas?

A

Pancreatic carcinoma

27
Q

Where in the pancreas are most carcinomas?

A

The head of the pancreas

28
Q

What is the most common subtype of pancreatic carcinoma?

A

Ductal adenocarcinoma

29
Q

Perineurial invasion is common in pancreatic carcinoma. t/f?

A

tRUE

30
Q

What is the biggest risk factor for pancreatic carcinoma?

A

Smoking

31
Q

What is the most common type of functional neuroendocrine pancreatic tumour?

A

Insulinoma

32
Q

Insulinomas are usually benign. T/F?

A

True

33
Q

How do insulinomas present?

A

Hypoglycaemia

34
Q

Malignant endocrine tumours of the pancreas have a better prognosis than pancreatic carcinoma. T/F?

A

True

35
Q

Why does carcinoma of the ampulla of Vater have a better prognosis than pancreatic carcinoma?

A

Because of its location, it presents at an earlier stage

36
Q

What subtype of cholangiocarcinoma has a similar morphology and prognosis to pancreatic carcinoma?

A

Extrahepatic cholangiocarcinoma

37
Q

How is extra hepatic cholangiocarcinoma treated?

A

Whipple’s operation to remove common bile duct and involved pancreas/duodenum

38
Q

Gallstones are present in most cases of gallbladder carcinoma. T/F?

A

True

39
Q

There is a poor prognosis for gallbladder carcinoma unless…?

A

It is found incidentally in a gallbladder removed due to chronic cholecystitis

GI/Liver (8 decks)

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