Flashcards in 60b Pancreatic pathology Deck (23)
Which enzymes does the exocrine pancreas secrete? (5)
How does acute pancreatitis present? (3)
Severe abdo pain radiating to lower back.
N + V.
Raised serum amylase/lipase.
What is the aetiology of acute pancreatitis? (6)
Rare: Vascular insufficiency
Viral: mumps, coxsackie B
Pathology in mild acute pancreatitis? (2)
Signs of severe acute pancreatitis? (2)
Swollen gland, fat necrosis.
Necrosis + haemorrhage.
Cullen's sign: haemorrhage into periumbilicus.
Grey Turner's sign: haemorrhage into subcutaneous flank.
How does pancreatitis change calcium and glucose levels in the blood?
What are the complications of acute pancreatitis? (4)
Pseudocysts (pancreatic juice collection)
Why are pseudocysts not true cysts?
No epithelial lining.
What is chronic pancreatitis?
What does it lead to?
Progressive inflammation with parenchyma destruction and fibrosis.
Destroys exocrine first, then endocrine.
Malnutrition + diabetes.
What are the causes of chronic pancreatitis?
Toxic: alcohol, cigarettes, high Ca, HPT
Genetic: CFTR, PRSS1, SPINK 1
Recurrent acute pancreatitis
Obstruction of main duct
What are the complications of chronic pancreatitis? (4)
Fat malabsorption: steatorrhea, low vit ADEK, diarrhoea, weight loss, cachexia.
Diabetes (late feature)
Stenosis of common bile duct/duodenum
What is the most common pancreatic cancer?
What are the risk factors for pancreatic adenocarcinoma? (7)
How does pancreatic adenocarcinoma present? (5)
After a decade of growth.
Non specific: epigastric pain radiating to back.
Weight loss, painless jaundice, puritis, nausea.
Trousseau’s syndrome (migratory thrombophlebitis)
Courvoisier’s sign (palpable gallbladder without pain).
What is the prognosis for pancreatic adenocarcinoma?
4% 5 year survival.
Mean survival is 3-5 months.
Extends to 10-20 with surgery (only 10% eligible).
Which hereditary cancer syndrome is p16/cdkn2A involved in?
Who gets pancreatic neuroendocrine tumours?
Increased risk? (2)
MEN 1, von Hippel Lindau
How common are poorly differentiated neuroendocrine carcinomas of the pancreas?
Rare - 2-3% of pancreatic neuroendocrine tumours.
Who gets poorly differentiated neuroendocrine carcinomas of the pancreas?
Males > Females
What is the only neuroendocrine tumour of the pancreas that is considered to be benign?
Which cell does a glucagonoma occur in?
Clinical findings? (4)
Stomatitis, rash, diabetes, weight loss.
Which cell does a gastrinoma occur in?
Clinical findings? (2)
Peptic ulcer, diarrhoea.
Which cell does a somatostatinoma occur in?
Clinical findings? (3)
δ cell (delta).
Diabetes, gallstones, hypochlorhydria.