Pancreatic Ca Flashcards
1
Q
- What is the most common type of pancreatic cancer?
A
Pancreatic ductal adenocarcinoma (PDAC).
2
Q
- What is the rank of pancreatic cancer in terms of cancer-related deaths?
A
Third leading cause of cancer death.
3
Q
- What is the 5-year survival rate for pancreatic cancer?
A
Approximately 7.2%.
4
Q
- What percentage of exocrine pancreatic malignancies does PDAC account for?
A
Over 90%.
5
Q
- What are the two main categories of risk factors for pancreatic cancer?
A
Lifestyle factors (e.g.
6
Q
- What is the most definitively identified risk factor for pancreatic cancer?
A
Tobacco smoking
7
Q
- How does smoking increase the risk of pancreatic cancer?
A
Carcinogens reach the pancreas via biliary-pancreatic reflux or the bloodstream.
8
Q
- What is the relationship between diabetes and pancreatic cancer?
A
Diabetes and prediabetes are risk factors and may also be a consequence of pancreatic cancer.
9
Q
- What percentage of PDAC patients have diabetes or impaired glucose tolerance at diagnosis?
A
50% to 80%.
10
Q
- What are precursor lesions to pancreatic cancer called?
A
Pancreatic intraepithelial neoplasia (PanIN).
11
Q
- What are the three grades of PanIN?
A
PanIN-1 (low grade)
12
Q
- What are intraductal papillary mucinous neoplasms (IPMNs)?
A
Precursor lesions that harbor invasive adenocarcinoma in 30-40% of cases.
13
Q
- Where do 60-70% of pancreatic cancers occur?
A
In the head or uncinate process of the pancreas.
14
Q
- What are the symptoms of right-sided pancreatic tumors?
A
Obstructive jaundice
15
Q
- What are the symptoms of left-sided pancreatic tumors?
A
Pain
16
Q
- What is Courvoisier’s sign?
A
A palpable gallbladder in the presence of jaundice
17
Q
- What are signs of advanced pancreatic cancer?
A
Cachexia
18
Q
- What is Virchow’s node?
A
Left supraclavicular lymph node enlargement
19
Q
- What is Sister Mary Joseph’s node?
A
A periumbilical nodule indicating metastatic spread of abdominal cancer.
20
Q
- What is Blumer’s shelf?
A
A palpable mass in the pouch of Douglas
21
Q
- What is the most common initial imaging study for pancreatic cancer?
A
Abdominal ultrasound.
22
Q
- What is the diagnostic and staging test of choice for pancreatic cancer?
A
Multidetector CT (MDCT) with pancreas protocol.
23
Q
- What is the accuracy of CT for predicting unresectable pancreatic cancer?
A
90% to 95%.
24
Q
- What is the accuracy of CT for predicting resectable pancreatic cancer?
A
80% to 90%.
25
25. What are the typical CT findings of pancreatic adenocarcinoma?
Hypodense mass
26
26. What is the role of endoscopic ultrasound (EUS) in pancreatic cancer?
It is highly sensitive for detecting small lesions (<2 cm) and assessing tumor stage.
27
27. What is the role of diagnostic laparoscopy in pancreatic cancer?
It improves the accuracy of predicting resectability to 98%
28
28. What are the three categories of pancreatic cancer staging?
Resectable
29
29. What is the median survival after surgical resection for pancreatic cancer?
16 to 20 months.
30
30. What is the median survival for unresectable pancreatic cancer?
6 to 12 months.
31
31. What is the goal of surgical treatment for pancreatic cancer?
R0 resection (complete removal with negative margins).
32
32. What is the surgical procedure for right-sided pancreatic tumors?
Pancreatoduodenectomy (Whipple procedure).
33
33. What is the surgical procedure for left-sided pancreatic tumors?
Distal pancreatectomy.
34
34. What is the role of neoadjuvant therapy in pancreatic cancer?
It may improve patient selection
35
35. What is the role of preoperative biliary drainage in pancreatic cancer?
It is used to relieve obstructive jaundice before surgery.
36
36. What is the role of CA19-9 in pancreatic cancer?
It is a tumor marker used for diagnosis and surveillance
37
37. What is the normal level of CA19-9?
Less than 37 U/mL.
38
38. What are the limitations of CA19-9 as a tumor marker?
It can be elevated in benign diseases
39
39. What is the role of MRI/MRCP in pancreatic cancer?
It is used for patients who cannot tolerate contrast and for better evaluation of cystic lesions.
40
40. What is the role of PET in pancreatic cancer?
It is used to detect distant metastases and assess tumor activity.
41
41. What is the role of ERCP in pancreatic cancer?
It is used for diagnostic and therapeutic purposes
42
42. What is the role of ERAS (Enhanced Recovery After Surgery) in pancreatic cancer?
It optimizes preoperative and postoperative care to improve recovery and outcomes.
43
43. What is the role of octreotide analogs in pancreatic cancer?
They are used to reduce pancreatic secretions and prevent postoperative complications.
44
44. What is the role of nutritional optimization in pancreatic cancer?
It involves correcting hypoalbuminemia and improving overall nutritional status before surgery.
45
45. What is the role of preoperative anticoagulation in pancreatic cancer?
It involves correcting coagulation abnormalities to reduce surgical risks.
46
46. What is the role of antibiotic prophylaxis in pancreatic cancer surgery?
It is used to prevent postoperative infections.
47
47. What is the role of total pancreatectomy in pancreatic cancer?
It is performed for extensive parenchymal involvement when partial resection is not feasible.
48
48. What is the role of adjuvant therapy in pancreatic cancer?
It is used after surgery to reduce the risk of recurrence and improve survival.
49
49. What is the role of palliative care in pancreatic cancer?
It focuses on symptom management and improving quality of life for unresectable or metastatic disease.
50
50. What are the key references for pancreatic cancer management?
Schwartz’s Principles of Surgery
