pancreatic endocrine neoplasms Flashcards
a pancreatic neuroendocrine tumor is a _ differentiated tumor of _ malignant potential
it is dervied from _ _ _
it can be functional or non functional
risk of malignancy depend on _ and _
grade is based on _ index and can be shown with a _ stain
well
low
pancreatic islet cells
stage (invasion) and grade
mitotic
Ki67
insulinomas are functionally active and a tumor of _ cells it is characterized by whipples triad, what is this
pancreatic neuroendocrine tumor
b cells
whipples triad: hypoglycemic symptoms (CNS dysfuctnion, confusion, visual changes, stupor)
low plasma glucose and relief with raising plasma glucose levels
insulinoma are almost always _ and are what color?
histologic feature
there is inappropiate high _ and concentration during spotneous hypoglycemia (fasting) can confirm diagnosis
benign
pale-brown-red
amyloid (from amylin)
insulin
what is factitious hypoglycemia
hypoglycemia due to inappropriate insulin use (administration of too much of a drug that causes beta cells to release insulin termed an insulin secretogougue)
c peptide is normally created by the body when _ is released
it will be low if _ insulin is being used
insulin
outside
labs for factiticous hypoglycemia
should be included in the workup of insulinoma
high insulin
low c peptide
a gastrinoma is a neuroendocrine tumor that secretes _ found in the _ triangle
gastrin
gastrin triangle
increased gastrin in a gastrinoma causes increased _ release from the pariteal cells and causes gastric/duodenal _
HCL
ulcers
duodenal ulcers and findings of a gastrinoma with peptic ulcer disease is termed
zollinger ellison syndrome
peptic ulcer disease symptoms
epigastric pain/discomfort
duodenal ulcer symptoms
symptoms after serverl hours after eating ; at night without food
more than half of the gatrinomas are _ and are associated with _ syndrome
you should suspect gatrinomas is there are multiple or if they are _ located
malignant
MEN1 syndrome
abnormally (jejunal)
how do you diagnose zollinger ellision syndrome due to gastrinoma
high fastinc gatrin and gastric pH lower than 2
a cell tumors produce _ and is associated with the 4 _
glucagonoma
D’s
dermatitis (necrolytic migratory erythema)
diabetes
depression
DVT ( coagulation factors)
increased glucagon
delta cell tumors are called _ with markedley high levels of _
somatostainomas
somatostatin
what does somatostatin do?
it suppresses insulin giving you diabetes
it suppresses cholecytokinin giving you cholethiasis
and it suppresses pancreatic enzymes giving you steatohrea
symptoms of somatostaninoma
delta cell tumor
diabetes, cholethliasis, steatorrhea
VIPomas are derived from _ _ cells and produced increased _
non beta
VIP (vasoactive intesintal peptide levels)
effect of a vipoma
cholera like secretory diarrhea with hypokalemia (secretion of electrolytes)
decreased acid in the stomach
