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FFP Acute abdominal pain and jaundice > Pathology > Flashcards

Pathology Flashcards

1
Q

What is chronic pancreatitis

A

Chronic inflammation with fibrosis and irreversible loss of pancreatic parenchyma

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2
Q

Commonest cause of chronic pancreatitis

A

Alcohol abuse

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3
Q

Clinical presentations of chronic pancreatitis

A 
Recurrent severe abdominal pain
Malabsorption
Jaundice
Abdo pain following food, alcohol or opiates
Symptomless
Diabetes
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4
Q

How to diagnose chronic pancreatitis

A

Abdo xray or

ERCP or MRCP of ducts

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5
Q

Aetiology of chronic pancreatitis

A 
repeated episodes of acute pancreatitis
Chronic alcohol abuse causing toxic damage to acini
Chronic pancreatic duct pbstruction
Cystic fibrosis 
HAemochromatosis
Hyperlipidaemia
Tropical pancreatitis 
Autoimmune pancreatitis 
Idiopathic
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6
Q

Morphology of pancreatitis

A

Fibrosis
Chronic inflammation
Destruction and atrophy of pancreatic acini
Islets of Langerhans initially spared
Duct strictures and dilatations
Hard shrunken pancreas containing plugged dilated ducts
May mimic cancer

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7
Q

Complications of chronic pancreatitis

A 
Malabsorption 
Diabetes
Pseudocysts 
Episodes of acute pancreatitis 
Pancreatic cancer if hereditary chronic pancreatitis 
Death
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8
Q

Commonest cause of acute pancreatitis

A

Gallstones

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9
Q

Presentation of acute pancreatitis

A

Severe abdo pain
N&V
Shock
It’s complication

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10
Q

Blood of acute pancreatitis

A 
elevated serum amylase and lipase
Hyperglycaemia in severe cases 
Mild elevation of ALP and bilirubin 
decreased serum albumin and calcium
Neutrophilia
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11
Q

Causes of acute pancreatitis

A

Pancreatic duct obstruction
Metabolic
Vascular (under perfusion of pancreas)
Infections

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12
Q

What can cause obstruction of pancreatic ducts

A 
Stones
Alcoholism 
Traume e.g. ERCP
Tumours 
Parasites
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13
Q

Metabolic conditions that cause acute pancreatitis

A 
Alcohol
Hyperlipidaemia 
Hypercalcaemia 
Drugs e.g. thiazide diuretics, morphine, steroids
Idiopathic
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14
Q

Which conditions can cause under perfusion of the pancreas which can cause ischaemic damage and acute pancreatitis

A 
SHock
Vasculitis
Atherosclerosis
Embolism of atheroma
Hypothermia
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15
Q

Infectious causes of acute pancreatitis

A 
Mumps
EBV
CMV 
Coxsackie virus
Mycoplasma pneumonia
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16
Q

What is the mechanism of damage in acute pancreatitis

A

Pancreatic enzymes released from damaged acinar cells

  • Enzymes include proteases, amylase, lipase and phospholipase.
  • Leads to necrosis of pancreatic tissue which leads to inflammation and haemorrhage
17
Q

Morphology of acute pancreatitis

A 
Inflammation
OEdema
NEcrosis
HAemorrhage
Fat necrosis from action of liberated lipase (make soaps due to fatty acids binding to calcium)
18
Q

Local complications of acute pancreatitis

A

Abscess formation

Pancreatic pseudocyst

19
Q

Systemic complications of acute pancreatitis

A 
Diabetes 
HYpocalcaemia 
Adult respiratory distress syndrome
Disseminated intravascular coagulation
Multiorgan failure
Death
20
Q

What is Meckel’s diverticulum

A

Incomplete regression of Vitelli-intestinal duct

21
Q

Complications of mockers diverticulum

A

MOst asymptomatic
May become inflamed resembling acute appendicitis
Heterotopic gastric mucosa may ulcerate, bleed and perforate
Intussusception

FFP Acute abdominal pain and jaundice (7 decks)

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