Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > Pancreatic and Biliary Disease > Flashcards

Pancreatic and Biliary Disease Flashcards

1
Q

what is acute pancreatitis?

A

reversible inflammatory process ranging in severity from oedema and fat necrosis to parenchymal necrosis and severe haemorrhage

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

risk factors for acute pancreatitis

A
  • gallstones

- alcoholism

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

how do gallstones lead to pancreatitis?

A

this obstructs the pancreatic duct which leads to irritation due to activation of pancreatic enzymes whilst in the organ, to cause inflammation of the pancreas

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

causes of acute pancreatitis

A
  • obstruction of the duct system
  • drugs: thiazides, azothiaprine, oestrogens, sulphonamides, methyldopa
  • infections: mumps, mycoplasma
  • metabolic: hypercalcaemic states
  • acute ischaemia: thrombosis, embolism
  • trauma
  • genetic: cationic trypsinogen and trypsin inhibitor mutations
  • idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pathogenesis of pancreatitis

A

pancreas is digested by its own enzymes being activated within the organ (autodigestion)

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

what activates the pancreatic enzymes?

A
  • duct obstruction
  • acinar cell injury
  • defective intracellular transport
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what happens when the duct gets obstructed?

A
  • interstitial oedema
  • impaired blood flow
  • ischaemia
  • acinar cell injury
  • leads to activation of enzymes
  • alcohol/trauma/drugs/viruses: release of intracellular proenzymes and hydrolases which activates enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens if there is defective intracellular transport?

A
  • delivery of proenzymes to lysosomal compartment, leading to activation of enzymes and acinar cell injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what happens when there is acinar cell injury?

A
  • interstitial inflammation and oedema
  • proteolysis
  • fat necrosis
  • haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what causes fat necrosis?

A

lipases and phospholipases

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

what does elastase do?

A

digests the walls of the blood vessels, leading to haemorrhage

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

clinical features of acute pancreatitis

A
  • abdominal pain
  • acute abdomen
  • elevated amylase, lipases
  • fat necrosis, hypocalcaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why is there hypocalcaemia in pancreatitis?

A

due to extensive fat necrosis, a lot of calcium is pulled out from the bloodstream, causing calcium deposits and hypocalcaemia

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

complications of pancreatitis

A
  • pancreatic abscess
  • pseudocyst
  • ARDS; renal failure
  • infection by gram negative organisms
  • shock
  • septicaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what type of damage is there in chronic pancreatitis?

A

irreversible

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

pathological features of chronic pancreatits

A
  • fibrosis
  • present with diabetes mellitus
  • recurrent pancreatitis attacks which slowly destroy the pancreas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

causes of chronic pancreatitis

A
  • alcohol abuse
  • long standing duct obstruction
  • hereditary pancreatitis
  • tropical pancreatitis
  • idiopathic
  • autoimmune pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pathogenesis of chronic pancreatitis

A
  • necrosis/fibrosis due to acute inflammation, leading to fibrosis, duct distortion and altered secretions, leading to loss of parenchyma and fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pathogenesis of hereditary pancreatitis

A
  • mutations in the PRSS1 gene

- this codes for autolysis-resistant trypsin, leading to pancreatitis

20
Q

complications of chronic pancreatitis

A
  • pseudocyst
  • malabsorption
  • diabetes
  • carcinoma
21
Q

clinical features of autoimmune pancreatitis

A
  • weight loss, abdominal pain, jaundice
  • imaging: diffuse enlargement of pancreas, narrowing of the duct
  • IgG4 plasma cells present
  • elevated serum IgG4
22
Q

if the patient presents with jaundice, which part of the pancreas is most likely affected?

A

head of the pancreas due to obstruction of a section or tributary of the CBD

23
Q

treatment of autoimmune pancreatitis

A

steroids

24
Q

IgG4 related immune disorders

A
  • biliary tree disorders like PSC
  • idiopathic retroperitoneal fibrosis
  • riedel thyroiditis
  • chronic sclerosing sialadenitis
25
Q

what can of tumours can occur in the pancreas?

A
  • cystic neoplasms
  • intraductal neoplasms
  • carcinoma
  • islet cell tumours
  • pancreatoblastoma
26
Q

what kind of tumours are pancreatic cystic tumours?

A

intraductal papillary mucinous tumours

27
Q

what is the common carcinoma in the pancreas?

A

adenocarcinoma

28
Q

aetiology of pancreatic carcinoma

A
  • elderly
  • smoking
  • chronic pancreatitis and diabetes
  • familial clustering (HNPCC, breast/ovary, FAMMM, hereditary pancreatitis)
29
Q

risk factors for gallstones

A
  • age
  • women (female, fertile, fat, forty, fair)
  • oestrogens
  • hereditary factors
30
Q

pathogenesis of cholesterol gallstones

A
  • cholesterol: bile gets supersaturated with cholesterol, gallbladder hypomotility promotes nucleation which accelerates cholesterol nucleation, mucus hypersecretion traps crystals, permitting aggregation into stones
31
Q

pathogenesis of pigment gallstones

A
  • infections (unconjugated bilirubin increases in infection)

- haemolysis

32
Q

what disease is almost always associated with gallstones?

A

cholecystitis

33
Q

what is cholecystitis?

A

acute inflammation precipitated by obstruction of neck or cystic duct

34
Q

causes of acalculus cholecystitis

A
  • post-op state
  • severe trauma
  • burns
  • multisystem failure/sepsis
  • portpartum
35
Q

complications of cholecystitis

A
  • empyema
  • gangrenous cholecystitis
  • ascending cholangitis
36
Q

what happens to the gallbladder in times of obstruction?

A
  • thickened walls

- becomes trabeculated

37
Q

where does a carcinoma of the gallbladder affect more commonly?

A
  • fundus

- neck

38
Q

what is the prognosis of pancreas and gallbladder cancers

A

poor

39
Q

types of liver benign tumours

A
  • liver cell adenoma

- cavernous haemangioma

40
Q

risks factors for hepatocellular carcinoma

A
  • HBV
  • HCV
  • alcoholic disease
  • haematochromatosis
41
Q

types of morphology of HCC

A
  • unifocal
  • multifocal
  • diffusely infiltrative
42
Q

what is fibrolamellar carcinoma associated with?

A

younger population

43
Q

risks of cholangiocarcinoma

A
  • PSC
  • caroli
  • parasites
44
Q

where does cholangiocarcinoma affect?

A

bile ducts in the liver

45
Q

where is the most common site for metastasis?

A

liver

46
Q

how would LFTs be with tumour infiltrating the liver?

A

they can still remain normal because there is enough normal viable tissue to compensate for the lost

Pathology (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions