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Medical Boards February 2013 > XVII - The Pancreas > Flashcards

XVII - The Pancreas Flashcards

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USMLE® Step 1 flashcards
1
Q

This disease is characterized by the following morphological changes: (1) microvascular leakage causing edema, (2) necrosis of fat by lipases, (3) an acute inflammatory reaction, (4) proteolytic destruction of parenchyma, (5) destruction of blood vessels with hemorrhage

A

Acute pancreatitis (TOPNOTCH) Robbins Basic Pathology, 8th ed., pg. 677

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2
Q

Extensive pancreatic parenchymal necrosis accompanied by diffuse hemorrhage.

A

Hemorrhagic pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 678

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3
Q

Cardinal manifestation of acute pancreatitis.

A

Abdominal pain(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 679

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4
Q

Necrosis of pancreatic tissue affecting acinar and ductal tissues as well as the islets of Langerhans; vascular damage causes hemorrhage into the parenchyma.Macroscopically, the pancreas exhibits red-black hemorrhage interspersed with foci of yellow-white, chalky fat necrosis.

A

Acute necrotizing pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 678

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5
Q

Solitary, 2-30 cm lesions of the pancreas, formed by walling-off of areas with hemorrhagic fat necrosis.Composed of necrotic debris encased by fibrous walls of granulation tissue, and lacks epithelial lining.

A

Pancreatic pseudocysts(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 679

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6
Q

Characterized by parenchymal fibrosis, reduced number and size of acini, and variable dilation of the pancreatic ducts. With relative sparing of Islets of Langerhans. Ductal concretions are present.

A

Chronic pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 680

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7
Q

Presents as painless, slow-growing cystic masses filled with thick, tenacious mucin, lined with columnar mucinous epithelium, associated with densely cellular stroma. Almost always arise in women.

A

Mucinous cystic neoplasm of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 681

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8
Q

Similar to mucinous cystic neoplasms but appear more frequently in men.

A

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 682

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9
Q

Most common location of pancreatic cancer.

A

Head of pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 684

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10
Q

Most common symptom of pancreatic carcinoma located at the tail and body of the gland?

A

None/AsymptomaticSince it does not impinge on the biliary tract, it may be quite large and widely disseminated by the time they are discovered.(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 684

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11
Q

Moderately to poorly differentiated adenocarcinoma forming abortive tubular structures or cell clusters and exhibiting an aggressive, deeply infiltrative growth pattern.

A

Pancreatic carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 684

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12
Q

Type of pancreatic carcinoma showing prominent acinar cell differentiation with zymogen granules and exocrine enzyme production.

A

Acinar cell carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 684

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13
Q

Type of pancreatic carcinoma with focal squamous differentiation in addition to glandular differentiation.

A

Adenosquamous carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 684

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14
Q

What is the most common clinically significant congenital anomaly of the pancreas?

A

Pancreas Divisum(TOPNOTCH)

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15
Q

This congenital abnormality develops embryologically when one portion of the ventral pancreatic primordium becomes fixed, while the other portion of this primordium is drawn around the duodenum

A

Annular Pancreas(TOPNOTCH)

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16
Q

What is the cardinal manifestation of acute pancreatitis?

A

Abdominal Pain(TOPNOTCH)

17
Q

The most common cause of acute pancreatitis is?

A

Excessive alcohol intake(TOPNOTCH)

18
Q

What are the 5 basic morphological alterations seen in Acute Pancreatitis?

A
  1. Edema caused by microvascular leakage2. Necrosis of fat caused by lipolytic enzymes3. Acute inflammatory reaction4. Destruction of pancreatic parenchyma by proteolytiz enzymes5. Destruction of blood vessels with subsequent interstitial hemorrage(TOPNOTCH)
19
Q

What is the most common cause of Chronic Pancreatitis?

A

Long term alcohol abuse(TOPNOTCH)

20
Q

This condition is characterized by parenchymal fibrosis, reduced number and size of acini with relative sparing of the islets of Langerhans, and variable dilation of the pancreatic ducts.

A

Chronic Pancreatitis(TOPNOTCH)

21
Q

What is the most constant morphological feature of Chronic Pancreatitis?

A

Acinar Loss(TOPNOTCH)

22
Q

60% of cancers of the pancreas arise in what area?

A

Head > Body > Tail(TOPNOTCH)

23
Q

What is the most frequently altered oncogene in pancreatic cancer?

A

K-RAS (TOPNOTCH)

24
Q

What is the most frequently inactivated tumor suppressor gene in pancreatic cancer?

A

p16(TOPNOTCH)

25
Q

What is the strongest environmental risk factor for developing Pancreatic Cancer?

A

Smoking(TOPNOTCH)

26
Q

What are the two characteristic features of Pancreatic Cancer?

A

Highly invasive and it elicits an intense non neoplastic host reaction called a desmoplastic response(TOPNOTCH)

27
Q

Where do Pancreatic cancers usually metastasize?

A

Lungs and bones(TOPNOTCH)

28
Q

This variant of Pancreatic cancer is characterized by formation of zymogen granules and the production of exocrine enzymes including trypsin and lipase`

A

Acinar cell carcinoma(TOPNOTCH)

29
Q

What is the first symptom of pancreatic cancer?

A

Pain(TOPNOTCH)

30
Q

These structures are formed by the walling off of areas of peripancreatic hemorrhagic fat necrosis with fibrous tissue and are usually composed of central necrotic hemorrhagic material rich in pancreatic enzymes surrounded by non epithelial lined fbrous walls of granulation tissue

A

Pseudocyts(TOPNOTCH)

31
Q

These kinds of cyst account for 75% of cysts seen in the pancreas

A

pseudocyts(TOPNOTCH)

32
Q

Gross morphology: extensive parenchymal necrosis accompanied by diffuse hemorrhage within the substance of the gland

A

Hemorrhagic pancreatitis(TOPNOTCH)

33
Q

Morphology: Pancreas shows region of fat necrosis and focal pancreatic parenchymal necrosis

A

Acute pancreatitis(TOPNOTCH)

34
Q

What is the most important triggering event in acute pancreatitis?

A

Activation of trypsinogen and subsequent autodigestion of the pancreatic substances(TOPNOTCH)

Medical Boards February 2013 (24 decks)

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