Wk3 Pancreas Gallbladder and biliary tract pathology

Question 1

autodigestion of the pancreas by innaproppriately released activated pancreatic enzymes

Answer 1

acute pancreatitis

Question 2

Main idea of acute panceatitis?

Answer 2

acinar cell injury

Question 3

irreversible acinar tissue loss/damage by remodeling and fibrosis

Answer 3

chronic pancreatitis

Question 4

IgG4 plasma cells

mimics pancreatic CA

Answer 4

Type I autoimmune pancreatitis

Question 5

storiform fibrosus

sarcoid-like

Answer 5

IgG4 related disease

Question 6

results from acute pancreatitis or trauma

lacks epithelial lining

contains pancreatic fluid secretions

Answer 6

Pseudocyst

Question 7

benign

glycogen rich cuboidal cells

clear, thin, straw colored fluid

Answer 7

Serous cystadenoma

Question 8

benign or malignant

large multi-loculated cysts

mucin filled

middle aged women

Answer 8

Mucinous cystic neoplasms

Question 9

“ovarian” type stroma

Answer 9

Mucinous cystic neoplasm

Question 10

mucinous neoplasm involving duct

precursor to pancreatic adenocarcinoma

head of the pancreas

Answer 10

Intraductal papillary mucinous neoplasm

Question 11

Most common pancreatic neoplasm

Answer 11

pancreatic exocrine carcinoma

Question 12

Most common location of pancreatic carcinoma:

Answer 12

head of the pancreas

Question 13

Painless jaundice Ddx?

Answer 13

pancreatic carcinoma

extrahepatic cholangiocarcinoma

gallbladder carcinoma

Question 14

Describe Whipple procedure:

Answer 14

removes head of pancreas, duodenum, common bile duct, gallbladder, antrum, and pylorus.

reconnects hepatic duct to jejunum, body/tail of pancreas, and body of stomach

Question 15

Most common location for pancreatic neuroendocrine tumors?

Answer 15

body or tail

Question 16

Big difference grossly between pancreatic carcinoma and neuroendocrine?

Answer 16

neuroendocrine are usually well circumscribed

Question 17

Why are functioning NE tumors usually smaller than non-functioning?

Answer 17

because their “function” is causing sx that lead to a search for their cause

Question 18

Majority of gallstones:

Answer 18

Cholesterol

Question 19

10% of gallstones:

Answer 19

pigmented

Question 20

Stones mostly comprised of bilirubin + Ca salts

Answer 20

pigmented

Question 21

Radioopaque type of gallstone?

Answer 21

pigmented

Question 22

imaging of choice for gallstone Dx?

Answer 22

ultrasound

Question 23

Population with higher risk of pigmented stones?

Answer 23

east asian

Question 24

Pigmented stones in a young person; think?

Answer 24

hemolytic disease process

biliary tract infx

**increased unconjugated bilirubin

Question 25

most common cause of extrahepatic biliary obstruction?

Answer 25

choledocholithiasis–stones in the common bile duct

Question 26

Stone size most likely to cause sx?

Answer 26

small

Question 27

edematous gallbladder with abscess, necrosis and neutrophilic infiltrate?

Answer 27

acute cholecystitis

Question 28

gallbladder with varying degrees of lymphocytic infiltration and and fibrosis?

Answer 28

chronic cholecytitis

Question 29

“porcelain gallbladder”

Answer 29

chronic cholecystitis

-dystrophic calcification of the gallbladder wall

Question 30

hypertrophy of the gallbladder muscular wall?

Answer 30

Adenomyoma

Question 31

Two big associations with carcinoma of the gallbladder?

Answer 31

age over 50

cholelithiasis (95%)

Question 32

Gallbladder carcinoma is_____?

Answer 32

rare!

..and typically silent

Question 33

Dx requirement for cholangiocarcinoma?

Answer 33

tissue biospy/cytology