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Alimentary > Pancreatic Pathology > Flashcards

Pancreatic Pathology Flashcards

1
Q

Define diverticular disease

A

Small sacs form in the wall of the large intestine, the mucosa and submucosa move out through the muscular layer. Most commonly occurs in the sigmoid colon.

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2
Q

What is the 5 year percentage survival for cancer of the pancreatic head ?

A

0.4 %

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3
Q

What are the risk factors for pancreatic cancer ?

A

Smoking
Diabetes
Chronic pancreatitis
FAP

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4
Q

How should pancreatic cancer be investigated ?

A

CT
Blood tests
EUS + FNA
PET scan

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5
Q

What is the palliative treatment for pancreatic cancer ?

A

ERCP and stent

PTC and bypass

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6
Q

If pancreatic cancer may be resectable how do you investigate ?

A

CT
MRI
UUS

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7
Q

What are the two main types of surgery for pancreatic cancer ?

A

PPPD

Whipples procedure

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8
Q

Define acute pancreatitis

A

Acute inflammatory process of the pancreas with variable involvement of other tissues

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9
Q

How is acute pancreatitis graded ?

A

Mild or severe

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10
Q

What complications can arise from pancreatitis ?

A

Abscesses
Cysts
Necrosis

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11
Q

What are the causes of acute pancreatitis ?

A 
G - Gallstones 
E - ERCP
T - Tumours 
S - Scorpion sting 
M - Mumps 
A - Anatomical abnormality 
S - Surgery 
H - Hyperlipidemia 
E - Alcohol
D - Drugs
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12
Q

What are the most common causes of acute pancreatitis ?

A

Drug, alcohol and gallstones

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13
Q

What are the main signs of acute pancreatitis ?

A
  • N/V
  • Indigestion
  • Fever
  • Diarrhoea
  • Weight loss
  • Jaundice
  • Abdominal tenderness and pain
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14
Q

How do you treat acute pancreatitis ?

A 
Analgesics 
IV fluids 
Antibiotics 
Nutrition and supplements - Enteral feeding 
Alcoholic counselling 
Steroids
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15
Q

How do you investigate acute pancreatitis ?

A 
Blood tests 
EUS
ECRP (Gallstones)
CT scan 
MRCP
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16
Q

How is acute pancreatitis classified ?

A

Glasgow criteria >3 then severe

17
Q

What is removal of the gallbladder known as ?

A

Cholecystectomy

18
Q

Define chronic pancreatitis

A

Chronic inflammatory process of the pancreas leading to chronic pain and impairment of function

19
Q

What are the causes of chronic pancreatitis ?

A 
O - Obstruction 
A - Autoimmune 
T - Toxins 
I - Idiopathic 
G - Genetic 
E - Environmental 
R - Recurrent injury
20
Q

How do you investigate chronic pancreatitis ?

A

CT scan

ERCP/MRCP

21
Q

How can chronic pancreatitis be managed ?

A 
Reduced fat intake 
Pancreatic supplementation
Abstinence from alcohol 
Stop smoking 
Analgesia
22
Q

What plexus may need to be blocked if pain is chronic and cannot be controlled ?

A

Coeliac plexus

23
Q

What is a mucinous cystic neoplasm ?

A

Small cystic lesion in the pancreas

24
Q

What does IPMN stand for ?

A

Intraductal pancreatic mucinous neoplasm

25
Q

Where is IPMN found ?

A

In the columnar duct cells that produce mucus

26
Q

What is the gold standard treatment for MCN ?

A

Resection in all fit patients

27
Q

What is the gold standard treatment for IPMN ?

A

Should be removed by if elderly then observe

28
Q

What levels are amylase usually found to be in acute pancreatitis ?

A

4 x the upper limit of norma

29
Q

What does CRP have to be at to indicate severe pancreatitis ?

A

> 150 mg/l

30
Q

How to you investigate necrosis ?

A

CT FNA

31
Q

How do you manage necrosis of the pancreas ?

A

Antibiotics and surgery

32
Q

How do you manage an abscess ?

A

Antibiotics and drainage

33
Q

What is a pseudocyst ?

A

Fluid collection without an epithelial lining

34
Q

How is a pseudocyst treated ?

A

Drainage if doesn’t resolve spontaneously

35
Q

Which 3 genes are associated with pancreatitis ?

A

SPINK1, CFTR, PRSS1

36
Q

What is the 5 year survival percentage for pancreatic cancer ?

A

15% operable , 1% if inoperable

Alimentary (12 decks)

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