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Endo II > Pathology of the Pancreas > Flashcards

Pathology of the Pancreas Flashcards

1
Q

acinar cells

A

exocrine pancreas

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2
Q

cell types in islets of langerhans

A

alpha
beta
delta
PP

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3
Q

insulin production

A

beta cells

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4
Q

glucagon production

A

alpha cells

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5
Q

somatostatin production

A

delta cells

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6
Q

pancreatic polypeptide production

A

PP cells

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7
Q

insulin

A

reduce blood sugar levels

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8
Q

glucagon

A

increase blood sugar levels

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9
Q

somatostatin

A

suppress insulin and glucagon release

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10
Q

pancreatic polypeptide

A

GI effects

-stimulates secretion of gastric and intestinal enzymes and inhibition of intestinal motility

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11
Q

D1 cells

A

in pancreas

elaborate vasoactive intestinal polypeptide

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12
Q

enterochromaffin cells

A

in pancreas

induce glycogenolysis and hyperglycemia

synthesize serotonin

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13
Q

carcinoid syndrome

A

pancreatic tumor - of enterochromaffin cells

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14
Q

predominant cell type in pancreas islet

A

beta cells - insulin

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15
Q

leading cause of ESRD, blindness, and amputations

A

diabetes mellitus

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16
Q

normal blood glucose

A

70-120 mg/dL

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17
Q

diagnosis of diabetes

A

fasting plasma glucose >126

random plasma glucose >200

2 hour plasma glucose >200 after oral glucose tolerance test

HbA1C level > 6.5%

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18
Q

pre-diabetes

A

fasting plasma glucose 100-125

2 hour plasma glucose 140-199 after oral glucose tolerance test

HbA1C 5.7-6.4%

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19
Q

DM I

A

autoimmune

beta cell destruction

insulin deficiency

patient younger than 20

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20
Q

DM II

A

peripheral resistance to insulin action and inadequate secretory response

majority of DM patients** 95%

older and obese**

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21
Q

increasing rate of obesity

A

more DM II in children an adolescents

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22
Q

nonketotic hyperosmolar coma

A

DM II

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23
Q

ketotic episodes

A

DM I

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24
Q

islet autoantibodies

A

anti-insulin
anti-GAD
anti-ICA512

DM I

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25
Q

GLA linkage

A

DM I

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26
Q

insulitis

A

inflammatory infiltrate of T cells and macrophages

beta cell depletion

islet atrophy

in DM I**

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27
Q

amyloid deposition in islets

A

DM II - chronic inflammation

28
Q

lymphocytes in islets

A

DM I

29
Q

honeymoon period

A

destruction beta cells during asymptomatic period

don’t notice until 90% destroyed

30
Q

unexplained fatigue, dizziness, blurred vision in obese patient

A

DM II

31
Q

most frequent diagnosis of DM II

A

routine blood testing in asymptomatic person

32
Q

polyuria, polyphagia, polydipsia

A

3 Ps of diabetes

33
Q

metabolic derangement in diabetes

A

ketoacidosis
hyperglycemia > polyuria

volume depletion

34
Q

diabetic coma

A

volume depletion and ketoacidosis

35
Q

vascular disease in diabetes

A

macrovascular - MI, stroke, lower extremity ischemia

microvascular - diabetic retinopathy, nephropathy, neuropathy

36
Q

atherogenic profile

A

in hypothyroidism

37
Q

increased number and size of islets in pancreas

A

nondiabetic newborns of diabetic mothers

islet hyperplasia - response to maternal hyperglycemia

38
Q

amyloid

A

extracellular

in DM II

39
Q

most common cause of death in diabetes

A

myocardial infarction

atherosclerosis of coronary arteries

40
Q

hyaline arteriosclerosis

A

in glomerulus

-diabetic microangiopathy

41
Q

35yo obese male, BUN/Cr elevation

A

most likely DM II

42
Q

diabetic nephropathy

A

glomerulosclerosis

arteriosclerosis of renal vasculature

pyelonephritis

43
Q

glomerular BM in diabetes

A

normal 200-300nm

diabetic 600nm

late stage 1200nm

44
Q

cataract

A

diabetes - hyperglycemia - opacification of lens

45
Q

chronic diabetes clinical

A

MI, renal vascular insufficiency, CVAs

diabetic nephropathy

visual impairment

distal symmetric polyneuropathy

enhanced susceptibility to infections

46
Q

pancreatic neuroendocrine tumor

A

PanNETs

islet cell tumor

47
Q

most common islet cell tumor

A

beta cell

-insulinoma

48
Q

insulinoma prognosis

A

90% benign

49
Q

second most common pancreatic tumor

A

zollinger ellison syndrome

-gastrinoma

50
Q

nonfunctional islet cell tumor

A

more likely malignant

51
Q

functional pancreatic endocrine neoplasms

A

hyperinsulinism
hypergastrinemia (ZES)
MEN - multiple endocrine neoplasia

52
Q

hypoglycemia episodes, confusion, stupor, loss of consciousness

precipitated by fasting or exercise and relieved by feeding

A

with insulinoma

53
Q

tumor in pancreas

A

insulinoma

54
Q

tumor around pancreas

A

malignant - gastrinoma

55
Q

45yo M exercises and faints, blood sugar low

A

insulinoma

56
Q

amyloid

A

seen in insulinomas

57
Q

insulinoma lab findings

A

high levels of insulin

high insulin:glucose ratio

58
Q

diarrhea, stomach pain, H2 blockers don’t get better, and multiple ulcers

A

ZES - gastrinoma

59
Q

most common ulcer in ZES

A

duodenum

60
Q

single gastrinoma

A

sporadic

61
Q

multifocal gastrinomas

A

familial - MEN-1

62
Q

jejunal ulcer

A

think ZES

63
Q

tx of ZES

A

H/K ATPase inhibitors and excision of neoplasm (whipple procedure)

64
Q

alpha cell tumor

A

glucagonoma

increased serum glucagon

65
Q

somatostatinomas

A

delta cell tumor

high plasma somatostatin

66
Q

VIPoma

A

watery diarrhea, hypokalemia, achlorhydria

WDHA syndrome

VIP assay - all patients with severe secretory diarrhae

67
Q

serotonin producing tumor

A

pancreatic carcinoid tumor

Endo II (12 decks)

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