Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gastrointestinal System > EXAM #3: PANCREATIC CANCER > Flashcards

EXAM #3: PANCREATIC CANCER Flashcards

(48 cards)

Start Studying
1
Q

Where is pancreatic cancer more prevalent geographically?

A

In well developed countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mortality associated with pancreatic cancer in the US?

A

4th leading cause of cancer mortality in the US

*Note that is also has the poorest prognosis of all cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the pancreas located?

A

Retroperitoneal in close proximity to the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two types of cells in the exocrine pancreas?

A

Acinar cells and duct cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common type of pancreatic cancer?

A

Adenocarcinoma arising from the exocrine pancreas (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you describe the histopathology of an adenocarcinoma?

A
  • Well differentiated cuboidal cells

- Duct-like structures that contain mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What oncogene is highly associated with pancreatic carcinoma?

A

K-ras (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What diseases are associated with pancreatic adenocarcinoma?

A
  • FAP
  • Peutz-Jeghers
  • Von Hippel-Lindau
  • MEN1
  • HNPCC
  • BRCA
  • Familial atypical multiple mole melanoma (FAMMM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the non-genetic risk factors for pancreatic cancer?

A
  • Age older than 45
  • Chronic pancreatitis
  • Smoking
  • DM
  • Diet high in fat/meat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What chemical exposures are risk factors for pancreatic cancer?

A

B-naphthylamine

Benzidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What surgical history is a risk factor for pancreatic cancer?

A

Partial gastrectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does pancreatic cancer typically present?

A

1) Abdominal pain
2) Weight loss
3) Jaundice
4) Steatorrhea
5) Pruritus

Elderly patient that develops glucose intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is pancreatic cancer diagnosed?

A

1) Spiral CT with IV contrast
- Determines mets and resectability
2) Confirm with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the determinants of resectablilty in pancreatic cancer?

A

1) No extrapancreatic disease

2) No direct tumor extension into the celiac axis and SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the utility of ERCP in pancreatic cancer?

A

1) Detection of small tumors not seen on CT

2) Palliation of biliary obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What sign on imaging is pathognomonic for pancreatic adenocarcinoma?

A

“Double-duct” sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is EUS?

A

Endoscopic US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the utility of EUS in pancreatic cancer?

A

1) Aid in diagnosis and characterization of lesion
2) Biopsy

EUS biopsy is associated with LESS peritoneal seeding compared to percutaneous CT guided biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the most common sites of metastasis for pancreatic adenocarcinoma?

A
  • Lung
  • Liver
  • Peritoneum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What stage are patients in when they start to experience symptoms of pancreatic cancer?

Study These Flashcards
A

T3= local invasion of bowel, bile duct, and major vessels

21
Q

What is the tumor marker for pancreatic cancer?

22
Q

Localization of pnacreatic cancer to which region of the pancreas is associated with earlier diagnosis?

Study These Flashcards
A

Head of the pancreas

23
Q

What is associated with decreased serial CA 19-9 levels following treatment?

Study These Flashcards
A

Increased survival

24
Q

What is the primary goal of treatment in pancreatic cancer?

Study These Flashcards
A

Symptom control

  • Pain
  • Weight loss
  • Pruritus
25
How is pain controlled in pancreatic cancer?
1) Opiates | 2) Celiac plexus neurolysis
26
How is weight loss managed?
Replacement of pancreatic enzymes
27
How is pruritus managed?
Anti-histamines SSRI Bile-acid binding resins
28
What procedure is used to resect the pancreas?
"Whipple procedure" or pancreaticoduodenectomy *Note that b/c of late stage diagnosis, 80-85% are NOT amenable to resection*
29
How is pancreatic cancer medically managed?
Chemotherapy 1) 5-FU 2) Gemcitabine *Note that 5-FU + Radiation was just as good as 5-FU alone
30
Generally speaking, what is the impact of intervention in the prognosis for pancreatic cancer?
Minimal--surgery buys more months than chemo, but both are only getting the patient more MONTHS
31
How common are cystic neoplasms?
Rare
32
What are the symptoms of a cystic neoplasm?
- Bloating - Weight loss - Obstructive jaundice
33
What is the most common type of cystic neoplasm?
Mucinous cystadenomas and Cystadenocarcinomas
34
What are the clinical features of Mucinous cystadenomas and Cystadenocarcinomas?
- More common in middle aged women | - Usually in body or tail of pancreas
35
What is intraductal papillary mucinous neoplasm?
Pancreatic precursor tumor
36
What are the clinical features of Intraductal papillary mucinous neoplasms?
- Men 60+ | - Recurrent pancreatitis from mucin obstructing the pancreatic duct
37
How are Cystic Neoplasms worked up?
1) Abdominal CT 2) EUS 3) Biopsy
38
What is the treatment for symptomatic, malignant or potentially malignant cystic neoplasms?
Surgical resection
39
List the various types of endocrine tumors.
- Insulinoma - Gastrinoma - Glucagonoma - VIPoma - Somatostatinoma
40
What is the most common type of endocrine tumor?
Insulinoma
41
What type of symptoms are seen with Insulinomas?
Generally, hypoglycemia in younger individuals
42
What is Whipple's Triad in Insulinomas?
1) Hypoglycemic sx. 2) Serum glucose less than 50 mg/dL 3) Relief with glucose adminstration
43
How is an Insulinoma diagnosed?
- 72 hour fast with insulin measurement | - Elevated c-peptide and proinsulin are confirmatory
44
What is the gold standard for imaging an insulinoma?
Intraoperative US and palpation
45
What is the typical presentation for Gastrinomas?
- Abdominal pain - PUD - GERD - Diarrhea
46
How are Gastrinomas diagnosed?
1) Elevated serum gastrin | 2) Secretin stimulation test
47
Where is the Gastrinoma triangle?
1) superior= cystic and common bile ducts 2) inferior= second and third parts of duodenum 3) medial= neck and body of the pancreas
48
How are Gastrinomas treated?
PPIs and surgical resection

Gastrointestinal System (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions