Sketchy Path: Pancreatic and Islet Cell Tumors Flashcards

1
Q

What is the most important RF for adenocarcinoma of the pancreas?

A

Smoking

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2
Q

What is the genetic mutation assc with familial pancreatic adenocarcinoma?

A

BRCA 1 and 2

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3
Q

What genetic mutation is present in almost all pancreatic cancers?

A

KRAS

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4
Q

What two tumor suppressor gene is a risk factor for pancreatic adenocarcinoma?

A

CDKN2A and SMAD4

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5
Q

Where is the most common place for pancreatic adenocarcinoma?

A

Head of the pancreas

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6
Q

What type of hyperbillirubinemia is caused by pancreatic adenocarcinoma?

A

Obstructs the common bile duct and leads to an increase of conjugated bilirubin -> pale/clay stools and dark urine

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7
Q

What is Courvoisier’s Sign?

A

A palpable non-tender gallbladder assc with Jaundice

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8
Q

Superficial migratory thrombophlebitis can be caused by pancreatic adenocarcinoma and is termed?

A

Trousseau’s Syndrome

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9
Q

Pancreatic Adenocarcinoma can cause what adrenal pathology?

A

Cushing Syndrome

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10
Q

What serum markers are elevated in pancreatic cancer?

A

CEA
CA 19-9
Not used to diagnose but can track progression

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11
Q

What part of the pancreas has neuroendocrine functions?

A

Islet of Langerhaans

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12
Q

What is the most common pancreatic neuroendocrine tumor?

A

Insulinoma

beta cell tumor

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13
Q

What signs would you get in a person with Insulinoma?

A

Hypoglycemia

Tremors, diaphoresis, and confusion

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14
Q

A patient with an insulinoma may tell you that they feel better after what?

A

They eat

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15
Q

What is Whipple’s Triad?

A

Hypoglycemia symptoms (tremors, confusion)
Feel better after eating
Low blood glucose

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16
Q

Besides insulin itself, what other molecule will be elevated in the blood?

A

C-Peptide
(only elevated when you are making too much ENDOGENOUS insulin therefore would not be elevated in someone who took too much synthetic insulin)

17
Q

Glucagonomas cause what?

A

Hypergylcemia

18
Q

What are some other symptoms of Glucagonomas?

A

GI Side effects
Weight Loss
Depression/Dementia
Dellusions

19
Q

A large percentage of patients with Glucagonoma will suffer what type of event?

A

Venous thrombosis (DVT or PE)

20
Q

What of the most classic features of Glucagonoma is what skin manifestation?

A

Necrolytic Migratory Erythema

epidural necrosis causing migrating erythematous plaques, usually affects extremities and perioral region

21
Q

Gastrinoma cause a cluster of symptoms known as?

A

Zollinger- Ellison Syndrome

22
Q

An ulcer in the Jejunum is a red flag for what?

A

Zollinger-Ellison / Gastrinoma

23
Q

What is the most common presenting symtpoms in those with ZE syndrome?

A

Diarrhea
Abd Pain
GERD

24
Q

What test can be performed if you are unsure of a gastrinoma?

A

Secretin Test

normally secretin would inhibit the release of gastrin but it has the opposite affect on a gastrinoma

25
Pancreatic Cholera occurs due to what tumor?
VIPomas
26
Large volumous diarrhea from a VIPoma can lead to what?
Hypokalemia Achlorhydria Dehydration
27
MEN1 has what tumors?
Pituitary Parathyroid Pancreatic
28
Somatostatinoma's symptoms?
Malabsorption diarrhea Gallstones (decrease CCK) Achlorhydria (decrease gastrin) Hyperglycemia
29
What drug can decrease the symtpoms of pancreatic neuroendocrine tumors?
Octerotide | mostly for VIPomas and Gastrinomas