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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
Sonographic findings of chronic pancreatitis...
``` Reduced size of the gland Increased echogenicity Irregular borders Calcification** Pseudocyst formation Atrophy Prominent duct ```
25
Describe hemorrhagic pancreatitis...
``` Progression of acute Decreased hematocrit Rupture of blood vessels Diffuse enzymatic destruction Necrotizing destruction Mass may be seen ```
26
With hemorrhagic pancreatitis, what is Grey Turner's sign?
Necrosis of blood vessels Discoloration of the flanks
27
Describe phlegmonous pancreatitis...
Areas of edema - pus filled fluid Extension outside the gland in 18-20% Extension into the peripancreatic tissue
28
Sonographic findings of phlegmonous pancreatitis...
``` Hypoechoic ill defined mass Irregular borders Involves lesser sac & pararenal space May proceed to necrosis ```
29
Clinical symptoms of pancreatic abscesses...
``` Secondary to pancreatitis May spread Leukocytosis Fever Nausea/vomiting ```
30
Sonographic findings of pancreatic abscesses...
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
_________ _________ Are fluid collections that arise from loculation of inflammation, necrosis or hemorrhage.
Pancreatic pseudocysts
32
Pancreatic pseudocysts are _________.
Acquired
33
Pancreatic pseudocysts form in the _________ space where enzymes have _________.
Potential space Escaped
34
Pancreatic pseudocysts develop through the _________ _________ and _________ _________.
Lesser omentum and lesser sac
35
With pancreatic pseudocysts, _________ and _________ are displaced.
Stomach and duodenum
36
Where can pancreatic pseudocysts be located?
Anterior to the pancreas Anterior pararenal space Take on contour of space
37
Sonographic findings of pancreatic pseudocysts...
Well defined Sonolucent Echogenic borders
38
3 pancreatic pseudocyst classifications...
Septated Internal echoes caused by hemorrhage or clot Rim of calcifications
39
Describe pseudocyst rupture...
5% Shock & peritonitis Erosion into other organs
40
_________ _________ _________ Are associated with underlying congenital disease that affect other organs.
Congenital cystic lesions
41
What disease can vary in size in various organs?
Autosomal dominant polycystic disease
42
What is Von Hippel-Lindau Disease?
``` Autosomal dominant condition Central nervous system & retinal hemangioblastomas Visceral cysts Pheochromocytomas Renal cell carcinoma Pancreatic cysts ```
43
What is cystic fibrosis?
Hereditary disease - autosomal recessive | Excessive production of mucus
44
Sonographic findings of cystic fibrosis...
Increase in echogenicity Small cysts Biliary sludge Thick folds in the GI tract
45
Describe solitary pancreatic cysts - true cysts...
Microscopic sacs Congenital or acquired More common in the head
46
What is a hereditary disorder of the exocrine gland seen in children and young adults?
Fibrocystic disease of the pancreas
47
Describe fibrocystic disease of the pancreas...
``` 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
What are the 2 types of cystic pancreatic neoplasm?
Macrocystic adenoma Microcystic adenoma
49
Describe macrocystic adenoma...
``` Mucinous Malignant or benign Middle age females Body & tail Well defined cysts with thick fluid & septations/mural nodules ```
50
Describe microcystic adenoma...
``` Rare Benign Middle age - elderly females Von Hippel-Lindau disease Well circumscribed mass Multiple tiny cysts ```
51
_________ Is the most common primary neoplasm found in the exocrine portion of the pancreas.
Adenocarcinoma
52
Statistics of adenocarcinoma...
5% of all cancer | 4th cause of cancer mortality after lung, breast, & colon
53
Adenocarcinoma is found in _________ _________.
Elderly males
54
Clinical symptoms of adneocarcinoma...
Jaundice Weight loss
55
Most frequent site for adenocarcinoma of the pancreas is? 2nd site? Last site?
Head (60-70%) Body (20-30%) Tail (5-10%)
56
Adenocarcinoma in the head of the pancreas can cause _________ _________. This will cause what 3 things?
CBD obstruction Jaundice, GB hydrops, Courvoisier GB
57
Sonographic findings of adenocarcinoma...
``` Loss of pancreatic parenchymal pattern Change in echogenicity Irregular borders CBD enlargement Dilation of the pancreatic duct Hydropic GB Liver mets Ascites ```
58
Adenocarcinoma can metastatically spread to the _________ & _________ and displace the _________ _________.
Liver and nodes SM vessels
59
Adenocarcinoma will compress the anterior wall of the ________ & cause _________ of any vessels.
IVC Displacement
60
Describe mucinous adenocarcinoma...
``` Also called colloid carcinoma Cystic appearance Tumor calcification Obstruction of bile ducts Poor prognosis ```
61
What is insulinoma? *type of endocrine pancreatic neoplasm*
Most common functioning islet cell tumor Hypervascular 10% malignant
62
Clinical triad of insulinoma?
Fasting hypoglycemia Symptoms of hypoglycemia Relief of symptoms after IV glucose
63
Symptoms of insulinoma?
``` Palpitation Headache Confusion Pallor Sweating Slurred speech Coma ```
64
What is gastrinoma? *type of endocrine pancreatic neoplasm*
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
Metastatic disease...
Uncommon 5% Melanoma, breast, GI, lung
66
4 types of parapancreatic neoplasms... **not super important
Lymphomas (malignant, may displace SM vessels) Lymphangiomas Paragangliomas Cystic teratomas
67
Describe pediatric pancreatic masses...
Very rare Insulinomas are occasionally seen Beckwith-Wiedeman Syndrome
68
What is Beckwith-Wiedeman Syndrome?
Overgrowth autosomal dominant disorder associated with gigantism, macroglossia, and pancreatic hyperplasia caused by neonatal hypoglycemia
69
What treats pancreatic ca?
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
What is it called when infection spreads into the lymph nodes?
Lymph mode adenopathy

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

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