Rubin's Pancreas Flashcards
describe embriology of the pancreas?
ventral and dorsal pancreas join to make the pancreatic duct of Wirsung
describe acinar cells?
zymogen granules
“failure of 2 ambryonic pancreatic ducts to fuse”
pancreatic divisim
Most common pancreatic congenital anomaly?
pancreatic divism
“pancreatic tissue occuring outside its normal location with abundent smooth muscle”
heterotropic pancreas
“developmental malformation in which the pancreas forms a ring around the duodenum”
annular pancreas
“homozygous mutation of heomeodomain transcription factor IPF1”
partial or complete pancreatic agenesis
“inflammation and hemorrhage of the pancreas”
acute pancreatitis
What causes acute pancreatitis?
release of pancreatic digestive enzymes (premature activation of trypson leads to activation of other pancreatic enzymes
What are the histologic findings of acute pancreatitis?
Patchy acinar cell and fat necrosis and a little inflammation
Two major risk factors for acute pancreatitis?
1- Gallstones
2- chornic alcohol consumption
Name 2 serum markers for acute pancreatitis?
Increased serum lipase and amylase
Name 5 complications of acute pancreatitis?
1- shock 2- pancreatic psuedocyst 3- pancreatic abscess 4- DIC 5- ARDS
“CT lined pocket that forms following acute pancreatitis–> surrounds liquifactive necrosis and pancreatic enzymes”
pancreatic pseudocyst
“fibrosis of pancreatic parenchyma due to progressive destruction”
chronic pancreatitis
Major adult and chilhood causes of chronic pancreatitis??
Adult–> alcohol
Child–> CF
Findings in CF generated chronic pancreatitis?
Mucous plugs
Findings in alcohol generated chronic pancreatitis?
Protein plugs from hypersecretion of enzymes
Most common pathological type of chronic pancreatitis?
chronic calcifying pancreatitis
Name 4 complications of chronic pancreatitis?
1- pancreatic insufficiency (malabsorbion and vit ADEK deficiency)
2- dystrophic calcification of pancreatic parenchyma
3- secondary T2DM
4- pancreatic carcinoma
“point mutations that increase trypsinogen and trypsin levels”
Hereditary pancreatitis
Most common adult pancreatic tumor?
Infiltrating ductal adenocarcinomas
Typical age of pancreatic cancer?
70yo
“preneoplastic ductal proliferation characterized by replacement of ductal epithelium with mucous epithelium”
Pancreatic intraductal neoplasia
2 major risk factors for pancreatic carcinoma?
smoking and chronic pancreatitis
Most common location of pancreatic carcinoma?
head of the pancreas
2 “signs” of pancreatic cancer?
Trousseau syndrome–> mgratory thrombophlebitis
Courvoisier sign–> acute painless gallbladder dilation and jaundice
Symptoms of migratory thrombophlebitis?
swelling, erythema and tenderness in extremites
“tumor cells that look nd acit like normal acinar cells and produce exocrine enxymes”
acinar cell carcinoma
Paraneoplastic syndromes of acinar cell carcinoma?
fat necrosis, polyarthralgia and peripheral eosinophelia
“pancreatic tumor of childhood associated withBeck Wideman syndrome”
Pancreatoblastoma
Serum marker for pancreatoblastoma?
alpha FP
“pancreatic tumor lined by glycogen risk cuboidal epithelium”
serous cystic neoplasm
“dilated pancreatic ducts lined by neoplastic mucinous epithelium and filled with mucous”
intraductal papillary mucinous neoplasm
“cystic neoplasm lined by mucous secreting epithelium with underlying cellular, ovarian type stroma”
mucinous cystic neoplasm
“tumor in girls and young women associated with degnerated areas filled with blood and necrotic debris”
solid psuedopapillary neoplasm
Endocrine pancreatic tumor that is associated with MEN1?
pancreatic gastrinoma
Syndrome associated with gastrinoma?
Zollinger - Ellison Syndrome
Symptoms of insulinoma?
hypoglycemia (confusion, blurred vision, sweathing, palpitations)
Symptoms of glucogonoma?
anemia, diabetes, necrolytic migratry erythema
Symptoms of somatostainoma?
cholelithiasis, diabetes, steatorrhea
Symptoms of VIPoma?
achlorhydria, severe diarrhea
