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Spring 2014 - ABD TEST 4 - PANCREAS ✔️ > Pathology > Flashcards

Pathology Flashcards

0
Q

Pancreatitis malformations are due to increased _________ and _________ of the ducts.

A

Secretion

Blockage

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1
Q

Pancreatitis is…

A

Inflammation of the pancreas

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2
Q

_________ _________ May be digested by its own enzyme.

A

Pancreatic tissue

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3
Q

What causes pancreatitis? The 5 B’s…

A 
Bile - biliary disease (most common)
Booze - alcoholism (2nd most common)
Blood - trauma
Bug - infectious process
Birth - congenital
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4
Q

Pancreatitis in children is caused by _________, specifically _________ _________. (Most common)

A

Trauma

Child abuse

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5
Q

Pancreatitis etiology in children are:

A

Trauma
Infectious processes - mumps & mono
Toxic exposure
Heredity

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6
Q

Acute pancreatitis = inflamed _________

A

Acini

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7
Q

The most common complication of acute pancreatitis is a _________.

A

Pseudocyst

*not filled with serous fluid, but instead enzyme fluid

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8
Q

Acute pancreatitis risks are _________ and _________.

A

Abscess and hemorrhage

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9
Q

Most common cause of acute pancreatitis is related to _________ _________.

A

Biliary disease

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10
Q

Second common cause of acute pancreatitis is _________.

A

Alcoholism

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11
Q

What causes acute pancreatitis?

A 
Trauma
ABD infection
Pregnancy
Mumps
Vascular thrombosis
Drugs
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12
Q

Acute pancreatitis will have an increase in _________ _________.

A

Pancreatic enzymes

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13
Q

What enzymes are associated with acute pancreatitis?

A

Amylase & lipase

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14
Q

With acute pancreatitis, amylase increases significantly within _________ hrs.

A

24 hrs

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15
Q

With acute pancreatitis, lipase increases within _________ hrs and remains _________.

A

72-94 hrs

Elevated

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16
Q

What are symptoms of acute pancreatitis?

A 
Abrupt onset of severe pain
Pain radiating to the back
Nausea & vomiting
Gallstones
Mild fever
Distention
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17
Q

_________ Pancreatitis cases can be resolved.

A

Mild

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18
Q

If pancreatitis progresses, it can turn into _________ and _________. There will be a decrease in _________.

A

Necrosis and hemorrhage

Hematocrit

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19
Q

Sonographic findings of pancreatitis…

A 
Swelling
Less echogenic than liver
Smooth to indistinct borders
Anterior compression of the IVC
Enlargement
Duct may be obstructed
Fluid collections
May be subtle
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20
Q

Clinical findings of pancreatitis…

A 
Acute pancreatitis
Elevated amylase (within 24 hrs)
Elevated lipase (within 72 hrs)
Pain
Fever
Nausea & vomiting
Leukocytosis
If hemorrhage - decreased hematocrit
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21
Q

Acute pancreatitis may obstruct _________ _________.

A

Pancreatic duct

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22
Q

Chronic pancreatitis deals with what 6 things?

A 
Repeated persistent
Fibrotic scarring
Psuedocyts
Dilated duct
Thrombosis of the splenic vein
Increased risk of cancer
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23
Q

Clinical symptoms of chronic pancreatitis…

A

Chronic pain
Nausea & vomiting
Weight loss
Jaundice

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24
Q

Sonographic findings of chronic pancreatitis…

A 
Reduced size of the gland
Increased echogenicity
Irregular borders
Calcification**
Pseudocyst formation
Atrophy
Prominent duct
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25
Q

Describe hemorrhagic pancreatitis…

A 
Progression of acute
Decreased hematocrit
Rupture of blood vessels
Diffuse enzymatic destruction
Necrotizing destruction
Mass may be seen
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26
Q

With hemorrhagic pancreatitis, what is Grey Turner’s sign?

A

Necrosis of blood vessels

Discoloration of the flanks

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27
Q

Describe phlegmonous pancreatitis…

A

Areas of edema - pus filled fluid
Extension outside the gland in 18-20%
Extension into the peripancreatic tissue

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28
Q

Sonographic findings of phlegmonous pancreatitis…

A 
Hypoechoic
ill defined mass
Irregular borders
Involves lesser sac & pararenal space
May proceed to necrosis
29
Q

Clinical symptoms of pancreatic abscesses…

A 
Secondary to pancreatitis
May spread
Leukocytosis
Fever
Nausea/vomiting
30
Q

Sonographic findings of pancreatic abscesses…

A

Poorly defined hypoechoic mass

If air is present, shadowing**

Fluid debris levels

Frequently associated with left side pleural effusion & splenomegaly (caused by splenic vein thrombosis)

31
Q

_________ _________ Are fluid collections that arise from loculation of inflammation, necrosis or hemorrhage.

A

Pancreatic pseudocysts

32
Q

Pancreatic pseudocysts are _________.

A

Acquired

33
Q

Pancreatic pseudocysts form in the _________ space where enzymes have _________.

A

Potential space

Escaped

34
Q

Pancreatic pseudocysts develop through the _________ _________ and _________ _________.

A

Lesser omentum and lesser sac

35
Q

With pancreatic pseudocysts, _________ and _________ are displaced.

A

Stomach and duodenum

36
Q

Where can pancreatic pseudocysts be located?

A

Anterior to the pancreas
Anterior pararenal space
Take on contour of space

37
Q

Sonographic findings of pancreatic pseudocysts…

A

Well defined
Sonolucent
Echogenic borders

38
Q

3 pancreatic pseudocyst classifications…

A

Septated
Internal echoes caused by hemorrhage or clot
Rim of calcifications

39
Q

Describe pseudocyst rupture…

A

5%
Shock & peritonitis
Erosion into other organs

40
Q

_________ _________ _________ Are associated with underlying congenital disease that affect other organs.

A

Congenital cystic lesions

41
Q

What disease can vary in size in various organs?

A

Autosomal dominant polycystic disease

42
Q

What is Von Hippel-Lindau Disease?

A 
Autosomal dominant condition
Central nervous system & retinal hemangioblastomas
Visceral cysts
Pheochromocytomas
Renal cell carcinoma
Pancreatic cysts
43
Q

What is cystic fibrosis?

A

Hereditary disease - autosomal recessive

Excessive production of mucus

44
Q

Sonographic findings of cystic fibrosis…

A

Increase in echogenicity
Small cysts
Biliary sludge
Thick folds in the GI tract

45
Q

Describe solitary pancreatic cysts - true cysts…

A

Microscopic sacs
Congenital or acquired
More common in the head

46
Q

What is a hereditary disorder of the exocrine gland seen in children and young adults?

A

Fibrocystic disease of the pancreas

47
Q

Describe fibrocystic disease of the pancreas…

A 
Pancreas is firm & normal size
Small cysts
Acini & ducts are dilated
Nausea & vomiting may occur
Pancreatic secretion is gradually lost
Jaundice may develop from duct obstruction
Diabetes is a late manifestion
Pancreatic duct may enlarge & contain calculi
48
Q

What are the 2 types of cystic pancreatic neoplasm?

A

Macrocystic adenoma

Microcystic adenoma

49
Q

Describe macrocystic adenoma…

A 
Mucinous
Malignant or benign
Middle age females
Body & tail
Well defined cysts with thick fluid & septations/mural nodules
50
Q

Describe microcystic adenoma…

A 
Rare
Benign
Middle age - elderly females
Von Hippel-Lindau disease
Well circumscribed mass
Multiple tiny cysts
51
Q

_________ Is the most common primary neoplasm found in the exocrine portion of the pancreas.

A

Adenocarcinoma

52
Q

Statistics of adenocarcinoma…

A

5% of all cancer

4th cause of cancer mortality after lung, breast, & colon

53
Q

Adenocarcinoma is found in _________ _________.

A

Elderly males

54
Q

Clinical symptoms of adneocarcinoma…

A

Jaundice

Weight loss

55
Q

Most frequent site for adenocarcinoma of the pancreas is? 2nd site? Last site?

A

Head (60-70%)

Body (20-30%)

Tail (5-10%)

56
Q

Adenocarcinoma in the head of the pancreas can cause _________ _________. This will cause what 3 things?

A

CBD obstruction

Jaundice, GB hydrops, Courvoisier GB

57
Q

Sonographic findings of adenocarcinoma…

A 
Loss of pancreatic parenchymal pattern
Change in echogenicity
Irregular borders
CBD enlargement
Dilation of the pancreatic duct
Hydropic GB
Liver mets
Ascites
58
Q

Adenocarcinoma can metastatically spread to the _________ & _________ and displace the _________ _________.

A

Liver and nodes

SM vessels

59
Q

Adenocarcinoma will compress the anterior wall of the ________ & cause _________ of any vessels.

A

IVC

Displacement

60
Q

Describe mucinous adenocarcinoma…

A 
Also called colloid carcinoma
Cystic appearance
Tumor calcification
Obstruction of bile ducts
Poor prognosis
61
Q

What is insulinoma?

type of endocrine pancreatic neoplasm

A

Most common functioning islet cell tumor

Hypervascular

10% malignant

62
Q

Clinical triad of insulinoma?

A

Fasting hypoglycemia
Symptoms of hypoglycemia
Relief of symptoms after IV glucose

63
Q

Symptoms of insulinoma?

A 
Palpitation
Headache
Confusion
Pallor
Sweating
Slurred speech
Coma
64
Q

What is gastrinoma?

type of endocrine pancreatic neoplasm

A

Young adults with peptic ulcer
Diarrhea
May be malignant
Small size
Occur mostly in body & tail in Langerhan’s islets
Zollinger-Ellsion syndrime (excessive secretion)

65
Q

Metastatic disease…

A

Uncommon 5%

Melanoma, breast, GI, lung

66
Q

4 types of parapancreatic neoplasms…

**not super important

A

Lymphomas (malignant, may displace SM vessels)
Lymphangiomas
Paragangliomas
Cystic teratomas

67
Q

Describe pediatric pancreatic masses…

A

Very rare
Insulinomas are occasionally seen
Beckwith-Wiedeman Syndrome

68
Q

What is Beckwith-Wiedeman Syndrome?

A

Overgrowth autosomal dominant disorder associated with gigantism, macroglossia, and pancreatic hyperplasia caused by neonatal hypoglycemia

69
Q

What treats pancreatic ca?

A

Whipple procedure - also called pancreatoduodenectomy

Stomach, GB duct, and rest of pancreas are reattached to the duodenum; GB and pancreatic ca tumor is removed

70
Q

What is it called when infection spreads into the lymph nodes?

A

Lymph mode adenopathy

Spring 2014 - ABD TEST 4 - PANCREAS ✔️ (2 decks)

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