pathology of the pancreas Flashcards
the most common causes of acute pancreatitis is ___ tract disease and excessive ___ ____
Billiary
alcohol intake
____ ___ is acute inflammation of the pancreas
acute pancreatitis
with acute pancreatitis there is elevated
- blood and urine ______
- blood _____
- ___ count
- ______
amylase
lipase
WBC
bilirubin
in acute pancreatitis blood and urinary amylase are elevated within first ____ hours and stays elevated for __-___ hours
24
48-72
with acute pancreatitis blood lipase elevated within ___-___ hours and stays elevated ___-___ days
48-72 hrs
5-14 days
some signs and symptoms of ACUTE pancreatitis are
- severe ___ pain which radiates to back ( after large meal or alcoholic Bev)
- nausea and vomiting
- ____
- abdominal ____
- fever
- _____
- history of gallstones and ____ abuse
epigastric
malaise
abdominal DISTENTION
jaundice
ALCOHOL abuse
on ultrasound ACUTE pancreatitis in the early stage may appear ____.
late stage shows an enlarged, ____echoic pancreas with possible pancreatic duct diation .
peripancreatic fluid collection with possible ____.
doppler shows ___ blood flow .
the gallbladder wall may be _____
normal
HYPOechoic
ascites
increased
thickened
there are 2 forms of ACUTE pancreatitis ____ form and ____ form
edematous
necrotizing
the most common form on pancreatitis is ____ form
edematous
some complications of ACUTE pancreatitis are
- ____ formation
- _____
- abscess
- _____
- duodenal _____
pseudocyst
phlegmon
hemorrhage
obstruction
pancreatic pseudocyst develops __-___ weeks onset of pancreatitis
4-6
the most common location for a pancreatic pseudocyst is the ___ sac anterior to the pancreas and ___ to the stomach.
The second most common location is in the anterior ___ space
lesser
posterior
pararenal
___ is used as a guidance modality in the approach to precutaneus drainage of pancreatic pseudocyst and abscess
ultrasound
for surgical or precutaneus intervention __ to ___ weeks is considered appropriate because by that time the walls of the pseudocyst are relatively well formed and the chances for spontaneous regression have diminished
five to six
pancreatic pseudocyst more common location is in the ___ ___
lesser sac
pancreatic pseudocyst second most common location is in the ___ ___ ___
anterior pararenal space
some complications with pancreatic pseudocyst are
- ____, infection and ____ rupture
bleeding
spontaneous
the most common complication of a pancreatic pseudocyst is ___ ___
spontaneous rupture
a spontaneous rupture clinical symptoms are sudden shock and ___, mortality rate is __% and pancreatic ____
peritonitis
50%
ascities
a complication of ACUTE pancreatitis is pancreatic ___ which is localized suppurative pus collecting in or around the gland
abscess
____ causes localized areas of diffused inflammatory edema or soft tissue.
its an inflammatory process that spreads along the fascial pathways
phlegmon
phlegmon may progress to ___ and suppuration. usually involves the __ sac, left anterior ___ space and transverse mesocolon.
occurs in 18-20% of patients with ___ ____
necrosis
lesser
pararenal
acute pancreatitis
phlegmon on ultrasound appears ___ texture with good through transmission
hypo echoic
____ pancreatitis is inflammatory reaction that spreads to the soft tissue surrounding the pancreas, along the fascial pathways producing edema and swelling
phlegmonous
a pancreatic ___ is imaged with sonography with poorly defined hypoechic mass with smooth or irregular thick walls causing few internal echoes
abscess
_____ pancreatitis is caused by a sudden escape of pancreatic enzymes into the parenchyma causing focal areas of fat necrosis in and around the pancreas which leads to rupture of the vessels and ____
hemmorhagic
hemorrhage
hemorrhagic pancreatitis is a rapid progression of ____ ____ with rupture of pancreatic ___ resulting in a ____
acute pancreatitis
vessels
hemorrhage
hemorrhagic pancreatitis on ultrasound appearance is varied , depending on the ___ of the hemorrhage ; ___ defined homogenous mass in the area of the pancreas may be seen , may appear ___ or ____
age
well
solid or cystic
____ ____ is an irreversible progressive destruction of pancreas due to repeated episodes of acute pancreatitis
CHRONIC pancreatitis
CHRONIC pancreatitis most common cause is ___ ___ associated with chronic ___ or ____ disease
alcohol abuse
alcoholism
biliary
CHRONIC pancreatitis increases risk of patient developing ____ ____
pancreatic cancer
with CHRONIC pancreatitis patients may also have ____ ( 20-40%) ,
a dilated ___ ___ ___ . or ___ of the splenic vein with extension into the ___ vein
pseudocyst
common bile duct
thrombosis
portal
some signs and symptoms of CHRONIC pancreatitis is
- constant ____ and ___ pain
- _____ loss
-_____
- _____ mellitus
epigastric and back
weight
steatorrhea
diabetes
CHRONIC pancreatitis on ultrasound appears ____geneous, small echogenic ____ may be seen ,
___ contours and ____ pancreatic duct
HETEROgeneous
calcifications
irregular
dilated
Endocrine neoplasms is also known as ____ cell tumors
Islet
Exocrine neoplasms is also called ____ cell tumors
Acini
The three types of islet cell tumors are
- ____ (B cell )
- _____
- ______ ( G cell)
Insulinoma
Glucagonoma
Gastrinoma
The most common islet cell tumor is _____ (60%) And the second most common is _____ (18%)
Insulinoma
Gastrinoma
Insulinoma (B cell ) is usually ____ and secretes ____.
Benign
Insulin
Glucagonoma is ___. High incidence of ___ .
Rare
Malignancy
Gastrinoma (G-cell) is the second most __\ functioning islet cell tumor and produces ___ -___ syndrome
Common
Zollinger Ellison
Gastrinoma is caused by non___ secreting pancreatic tumors , which secrete excessive amounts of ___
Insulin
Gastrin
With Glucagonoma patients are ____ caused by increasing level of the glucagon hormone
Hyperglycemic
Insulinoma , Glucagonoma and Gastrinoma are usually found on the pancreas ___ and ____
Body
Tail
The types of acini cell tumors are
- ______
- _______
- _____/_____
Adenocarcinoma
Serous cystadenoma
Mucinous cystadenoma / cystadenocarcinoma
Adenocarcinomas are ___ tumors of pancreas ranked as ___ th leading cause of cancer related deaths in the US
Malignant
4
____ accounts for 90% of all pancreatic malignancies. It can produce ___ gallbladder which is dilated CBD and GB
Adenocarcinoma
Courvoisier
With adenocarcinoma lab values show elevated
- _______
- _______
-________
- _____ phosphate
Bilirubin
Amylase
Lipse
Alkaline
____ is a rare neoplasm it can be serous or mucinous
Cystadenoma
With cystadenoma most are ____ but does have ____ potential this would be called _____
Benign
Malignant
Cystadenocarcinoma
SEROUS cystadenoma is a ___ tumor . It’s more common in ___
Benign
Women
MUCINOUS cystadenoma or cystadenocarcinoma is a ___ tumor but can become ____ and is most common in ____
Benign
Malignant
Woman
SEROUS cystadenoma is commonly found in the pancreas ____.
MUCINOUS cystadenoma is commonly found on pancreas ___/____
Head
Body/ tail
____ _____ is an adenocarcinoma most common type
Pancreatic carcinoma
Pancreatic carcinoma involves ____ portions of pancreas
Exocrine
Pancreatic carcinoma accounts for more than 90% of all ____ pancreatic tumors
Malignant
Pancreatic carcinoma affect ____ people more that ____
Black
White
Pancreatic carcinoma affects ____ more than ____
Males
Females
Patients are at risk for pancreatic carcinoma with a diet high in ___ .
Increase with ___. Family ____ correlation
____ pancreatitis . And with ____
Fats
Smoking
History
CHRONIC
Age
_____ ____ is the 4th most common cause of cancer related to breast and colon cancers
pancreatic carcinoma
lab values that relate to pancreatic carcinoma are elevated ______, _____, ______ and ______ phosphatase
bilirubin
amylase
lipase
alkaline
the Courvoisier gallbladder sign is seen with ____ _____
pancreatic carcinoma
pancreatic carcinoma is most common in the pancreatic _____, it appears as a ____ echoic mass and _____ defined. its usually greater than __cm.
head
HYPOechoic
poorly
2cm
with pancreatic carcinoma on ultrasound you can see the dilated ___ ___ ( including intrahepatic ducts) through the ____. and division of ____ duct. Liver ____, ascites and regional _____
biliary tree
CBD
Pancreatic
mets
adenopathy
pancreatic carcinoma appears ____echoic with ____ boarder mass located on the ____ of the pancreas. Dilated ____
HYPOechoic
irregular
head
CBD
_____ _____ is an inherited disorder of the exocrine glands causing viscous ( thick mucous) secretion and dysfunction of the pancreas exocrine function
Cystic fibrosis
with cystic fibrosis the pancreas becomes ____ and ___ replacement occurs
fibrotic
fatty
cystic fibrosis can cause pancreatic duct ____
obstruction
with cystic fibrosis there is pancreas ____ with increased ____ caused by fat replacement of the pancreatic tissue
atrophy
echogenecity
