Exocrine Pancreas Flashcards Preview

Unit 6: Pathology > Exocrine Pancreas > Flashcards

Flashcards in Exocrine Pancreas Deck (24):
1

What is an annular pancreas? What is the patient at risk for?

developmental malformation
pancreas forms a ring around the duodenum
at risk for duodenal obstruction

2

What kind of necrosis in acute pancreatitis?

liquefactive necrosis of pancreatic parencyhma
fat necrosis of surrounding fat

3

What are the most common causes of acute pancreatitis?

alcohol and gallstones

4

What are some other causes of acute pancreatitis?

1. trauma
2. hypercalcemia
3. hyperlipidemia
4. drugs - thiazides
5. scorpion stings - lol random
6. mumps
7. rupture of posterior duodenal ulcer

5

What is the clinical presentation of acute pancreatitis?

epigastric pain that radiates to the back
n/v , elevation of lipase and amylase
hypocalcemia - saponification uses up ca

6

What is the microscopic appearance of the pancreas in acute pancreatitis?

1. acinar cell necrosis
2. intense acute inflamm.
3. foci of necrotic adipocytes - patchy

7

What are some complications of acute pancreatitis?

1. hypovolemic shock
2. pancreatic pseudocysts
3. pancreatic abscess - ecoli
4. DIC and ARDs

8

What are the most common causes of chronic pancreatitis?

alcohol and CF

9

What is the clinical presentation of chronic pancreatitis?

chronic epigastric pain radiating to back
steatorrhea and malabsorption of ADEK
weight loss

10

Why arent amylase and lipase good markers for chronic pancreatitis?

they are totally destroyed by this point

11

What are some unfortunate complications of chronic pancreatitis?

secondary DM
inc risk for pancreatic carcinoma

12

What is the appearance of the pancreas in chronic pancreatitis?

parenchyma is firm and cut surface lacks lobules
shrunken, fibrotic, infiltrates of lymphocytes
ducts are dilated with proteinaceous material
pseduocysts are present

13

What are the risk factors for pancreatic carcinoma?

1. smoking
2. chronic pancreatitis
3. Obesity
4. DM

14

What are some gene mutations involved in the development of pancreatic carcinoma?

kras --> p16 --> p53, BRCA2, DPC4/SMAD4

15

Where is the most common site of pancreatic carcinoma?

the head of the pancreas

16

What is a common site of metastasis of pancreatic cancer?

the liver

17

Why is persistent pain a common finding in pancreatic carcinoma?

perineural invasion

18

If pancreatic carcinoma occurs in the head, describe some clinical findings?

obstructive jaundice with pale stools and palpable GB

19

If pancreatic carcinoma occurs in the body or tail, describe some clinical findings?

secondary DM

20

What is the treatment for pancreatic carcinoma?

whipple procedure
removes head and neck, duodenum, GB

21

What is a paraneoplastic syndrome that can occur with acinar cell carcinoma?

sc fat necrosis, polyarthralgia, eosinophilia
all due to hypersecretion of lipase

22

What inc risk for serous cystadenomas?

VHL mutation

23

What are the common mutations associated with pNETs?

MEN1 and VHL

24

What do pNETs stain positive for?

chromogranin A and synaptophysin