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GI - Week 2 > Pancreatic pathology > Flashcards

Pancreatic pathology Flashcards

1
Q

Does the endocrine or exocrine pancreas contain islets?

A

Endocrine

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2
Q

Does the endocrine or exocrine pancreas contain acinar architecture and ducts?

A

Exocrine

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3
Q

Is the pancreas mostly endocrine or exocrine by mass?

A

Exocrine

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4
Q

These cells of the pancreas have zymogen granules with proenzymes
Release mediated by high intracellular calcium

A

Acinar cell

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5
Q

Acinar cells have zymogen granules with proenzymes, and release is mediated by high levels of this

A

Intracellular calcium

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6
Q

This common condition occurs when the ducts of two pancreatic buds remain separate (fail to fuse)

A

Pancreas divisum

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7
Q

Is Pancreas divisum symptomatic?

A

Mostly asymptomatic

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8
Q

Pancreas divisum patients have a risk of this condition

A

Pancreatitis

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9
Q

This rare anomaly occurs with fusion of pancreatic buds and encircling of duodenum

A

Annular pancreas

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10
Q

Annular pancreas is an anomaly with fusion of these structures

A

Pancreatic buds and encircling of duodenum

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11
Q

When do patients with Annular pancreas usually present?

A

In 1st year of life
(with duodenal obstruction)

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12
Q

This pancreas condition usually presents in the first year of life with duodenal obstruction

A

Annular pancreas

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13
Q

An infant with post-prandial vomiting (after eating), abdominal distention, and double bubble sign likely has this condition

A

Annular pancreas

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14
Q

“Double bubble” sign is when two bubbles are seen in these separate structures

A

Stomach and Proximal duodenum

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15
Q

The “double bubble” sign is a gas bubble in the stomach, and a gas bubble in this portion of the duodenum

A

Proximal duodenum

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16
Q

In annular pancreas, there will be absence of air distal to this part of the pancreas

A

Proximal pancreas

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17
Q

Annular pancreas involves a localized obstruction to this part of the duodenum

A

Proximal duodenum

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18
Q

This condition of the pancreas is associated with duodenal atresia, which can cause polyhydramnios

A

Annular pancreas

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19
Q

Annular pancreas is associated with this condition, which can cause polyhydramnios

A

Duodenal atresia

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20
Q

Acute pancreatitis is pancreatic injury and inflammation from release of this

A

digestive enzymes

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21
Q

Acute pancreatitis occurs when there is premature enzyme activation within the pancreas, rather than this

A

Intestine

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22
Q

Trypsinogen is activated to this

A

Trypsin

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23
Q

In acute pancreatitis, premature enzyme activation within the pancreas leads to autodigestion of pancreatic parenchyma, resulting in this

A

Liquefactive necrosis

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24
Q

Omental saponification occurs in this condition

A

Acute pancreatitis

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25
Q

What are the two main mechansisms of acute pancreatitis?

A

Pancreatic duct stasis/obstruction
Acinar cell injury

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26
Q

The two mechanisms of this condition are pancreatic duct stasis/obstruction and acinar cell injury

A

Acute pancreatitis

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27
Q

This mechanism of acute pancreatitis can be caused by gallstones or tumors

A

Pancreatic duct stasis/obstruction

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28
Q

This mechanism of acute pancreatitis can be caused by alcohol or toxins

A

Acinar cell injury

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29
Q

The majority of acute pancreatitis cases are due to these two risk factors

A

Gallstones and alcohol

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30
Q

“I GET SMASHED” is a pneumonic describing the causes/associations of this condition

A

Acute pancreatitis

Iatrogenic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion stings
Hypercalcemia/hypertriglyceridemia
ERCP (endoscopic retrograde cholangiopancreatography)
Drugs

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31
Q

Pancreatic edema, necrotic pancreatic acini, and saponification are seen morphologically in this condition

A

Acute pancreatitis

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32
Q

Where is the location of abdominal pain in acute pancreatitis?

A

Central location (perigastric)

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33
Q

Is abdominal pain in acute pancreatitis better or worse when supine?

A

Worse

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34
Q

Abdominal pain in a central location (perigastric), that is worse when supine and radiates to the back, is seen in this condition

A

Acute pancreatitis

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35
Q

This condition will have a >3 fold elevation of amylase and/or lipase

A

Acute pancreatitis

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36
Q

What are the levels of amylase and lipase in acute pancreatitis?

A

Elevated
(>3 fold increase)

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37
Q

This enzyme that is elevated in acute pancreatitis is less specific, and decreases before pancreatitis subsides

A

Amylase

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38
Q

This enzyme that is elevated in acute pancreatitis is only made in the pancreas, and stays elevated for duration

A

Lipase

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39
Q

Parenchymal variable perfusion and necrosis, and peripancreatic fat edema and necrosis are seen radiographically in this condition

A

Acute pancreatitis

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40
Q

Is hypo- or hypercalcemia seen in acute pancreatitis?

A

Hypocalcemia

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41
Q

Is hypo- or hyperglycemia seen in acute pancreatitis?

A

Hyperglycemia

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42
Q

Hypovolemia-increased hematocrit, hypocalcemia, hyperglycemia, and systemic inflammatory syndrome are clinically seen in this condition

A

Acute pancreatitis

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43
Q

This complication of acute pancreatitis is liquefactive necrosis surrounded by fibrous wall

A

Pseudocyst

44
Q

What are the contents of a pseudocyst?

A

Necrotic materal; liquefied or granular

45
Q

A cyst that is high in amylase and digestive enzyme is this type

A

Pseudocyst (seen in acute pancreatitis)

46
Q

Does the wall of a pseudocyst have an epithelial lining?

47
Q

The wall of a pseudocyst is made of this

A

Fibrosis and granulation tissue

48
Q

The Grey turner sign (plank bruising) occurs due to this, which is a complication of acute pancreatitis

A

Retroperitoneal hemorrhage

49
Q

Cullen sign (periumbilical bruising) is seen in acute pancreatitis due to this complication

A

Retroperitoneal hemorrhage

50
Q

How does pleural effusion occur with acute pancreatitis?

A

Edema fluid crosses diaphragm

51
Q

What causes respiratory distress in acute pancreatitis?

A

Phospholipase (lecithinase activity)

52
Q

This is fibrotic replacement of pancreatic parenchyma, often after multiple episodes of acute pancreatitis

A

Chronic pancreatitis

53
Q

Is chronic pancreatitis reversible?

A

No, irreversible

54
Q

End stage chronic pancreatitis includes destruction of these

A

Islets (endocrine pancreas)

55
Q

Parenchymal calcifications seen on imaging of the pancreas indicate this condition

A

Chronic pancreatitis

56
Q

Chronic, persistent abdominal pain, that is often precipitated by meals or ethanol, indicate this condition
Also low grade amylase/lipase elevation
Malabsorption, weight loss

A

Chronic pancreatitis

57
Q

Chronic pancreatitis can cause deficiency of these vitamins

A

Fat-soluble vitamins (A, D, E, K)

58
Q

Acinar parenchyma replaced with fibrous tissue, as well as a firm, fibrotic pancreas organ with loss of lobular architecture, are seen morphologically in this condition

A

Chronic pancreatitis

59
Q

Are calcifications seen in acute or chronic pancreatitis?

60
Q

This autoimmune type of chronic pancreatitis is IgG4 mediated; multisystem disorder

61
Q

This autoimmune type of chronic pancreatitis is limited to the pancreas; not IgG4 mediated

62
Q

These two genes are associated with persistent or inappropriate trypsin inactivation, causing chronic pancreatitis

A

PRSS1 and Spink1

63
Q

PRSS1 and Spink1 cause persistent or inappropriate trypsin inactivation, resulting in this condition

A

Chronic pancreatitis

64
Q

PRSS1 and Spink1 are associated with chronic pancreatitis because they cause persistent or inappropriate inactivation of this compound

65
Q

Is secondary diabetes a complication of acute or chronic pancreatitis?

66
Q

What is the mechanism by which cystic fibrosis causes pancreatitis?

A

Thick secretions –> duct obstruction

67
Q

Delayed passage of the first stool can indicate this condition due to thick stools

A

Cystic fibrosis

68
Q

Pancreatic adenocarcinoma arises from this

A

Ductal epithelium

69
Q

This malignancy of the pancreas arises from ductal epithelium

A

Pancreatic adenocarcinoma

70
Q

This is the most common pancreatic malignancy

A

Pancreatic adenocarcinoma

71
Q

This part of the pancreas most commonly has Pancreatic adenocarcinoma

A

Head > body > tail

72
Q

Chronic alcohol intake, chronic pancreatitis, smoking, and high fat diet are risk factors for this, which is the most common pancreatic malignancy

A

Pancreatic adenocarcinoma

73
Q

Mutation of this oncogene is most commonly involved in Pancreatic adenocarcinoma

74
Q

KRAS oncogene mutations are most common in genetics of this pancreatic malignancy

A

Pancreatic adenocarcinoma

75
Q

p53, SMAD4, and p16 are tumor suppressors that can be lost in this pancreatic condition

A

Pancreatic adenocarcinoma

76
Q

Infiltrative glands within abundant desmoplastic stroma, and frequent perineural invasion, are seen morphologically in this condition of the pancreas

A

Pancreatic adenocarcinoma

77
Q

Painless jaundice, pain that radiates to the back, weight loss, anorexia, depression, and diabetes can be seen clinically in this condition

A

Pancreatic adenocarcinoma

78
Q

This condition is migratory thrombophlebitis (blood clots) that can be seen clinically in Pancreatic adenocarcinoma

A

Trousseau syndrome

79
Q

Troussea syndrome (migratory thrombophlebitis) can be seen in this pancreatic malignancy

A

Pancreatic adenocarcinoma

80
Q

This is a tumor marker used to follow Pancreatic adenocarcinoma; is NOT used for screening

81
Q

Ca 19-9 is a tumor marker used to follow this pancreas disease
Is not used for screening

A

Pancreatic adenocarcinoma

82
Q

Ampullary adenocarcinoma (of Ampulla of Vater) has divergent differentiation of these two tissue types

A

Intestinal
Pancreato-biliary

83
Q

Congenital pancreatic cysts can be microscopic to this size

84
Q

Congenital pancreatic cysts are lined by this type of epithelium

85
Q

Elevated intracystic pressure from secretions may flatten epithelium in this anomaly

A

Congenital pancreatic cysts

86
Q

Cysts in polycystic kidney diseases are possible but less likely in the pancreas, and are lined by this type of epithelium

A

Simple layer of cuboidal or compressed epithelium

87
Q

This is the most common cyst of the pancreas

A

Pseudocyst

88
Q

Benign neoplasm with VHL (von Hippel Lindau gene) mutations and bland serous cysts

A

Serous cystadenoma

89
Q

Serous cystadenoma is a benign neoplasm with gland serous cysts, and mutations in this gene

A

VHL (von Hippel Lindau gene)

90
Q

Are males or females more likely to have Serous cystadenoma?

A

Females
(>50 years old usually)

91
Q

This is a precursor lesion to mucinous adenocarcinoma
(1/3 malignant, 2/3 benign)

A

Mucinous cystic neoplasm

92
Q

Mucinous cystic neoplasm involves mutations in this

93
Q

Is Mucinous cystic neoplasm more common in males or females?

A

Almost always women

94
Q

Mucinous cystic neoplasm is most common in this part of the pancreas

A

Body or tail

95
Q

Is Mucinous cystic neoplasm connected to the ductal system?

96
Q

This precursor lesion to mucinous adenocarcinoma is almost always women, most common in body or tail of pancreas, and not connected to ductal system

A

Mucinous cystic neoplasm

97
Q

This precursor lesion to mucinous adenocarcinoma is more common in men, arises in head of pancreas, and grows within or connected to ductal system

A

Intraductal papillary mucinous cystic neoplasm (IPMN)

98
Q

Is Intraductal papillary mucinous cystic neoplasm (IPMN) more common in males or females?

99
Q

Intraductal papillary mucinous cystic neoplasm (IPMN) arises in this part of the pancreas

100
Q

Does Intraductal papillary mucinous cystic neoplasm (IPMN) grow within the ductal system?

A

YES - within or connected to

101
Q

Intraductal papillary mucinous cystic neoplasm (IPMN) has abundant production of this

102
Q

This precursor lesion to mucinous adenocarcinoma has abundant mucin production

A

Intraductal papillary mucinous cystic neoplasm (IPMN)

103
Q

Solid pseudopapillary tumors are mostly in this age group and gender

A

Adolescent / young adult females

104
Q

Are Solid pseudopapillary tumors sympomatic?

A

Asymptomatic or mild abdominal discomfort

105
Q

In Solid pseudopapillary tumors, epithelial cells adhere to this

A

Vessels
(remainder of tumor expands producing a papillary appearance)

106
Q

This tumor involves epithelial cells adhering to vessels, and the remainder of the tumor expands producing a papillary appearance

A

Solid pseudopapillary tumors

GI - Week 2 (12 decks)

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