Exocrine Pancreas Flashcards Preview

Unit 6: Pathology > Exocrine Pancreas > Flashcards

Flashcards in Exocrine Pancreas Deck (24)
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1
Q

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

A

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

2
Q

What kind of necrosis in acute pancreatitis?

A

liquefactive necrosis of pancreatic parencyhma

fat necrosis of surrounding fat

3
Q

What are the most common causes of acute pancreatitis?

A

alcohol and gallstones

4
Q

What are some other causes of acute pancreatitis?

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

What is the clinical presentation of acute pancreatitis?

A

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

6
Q

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

A
  1. acinar cell necrosis
  2. intense acute inflamm.
  3. foci of necrotic adipocytes - patchy
7
Q

What are some complications of acute pancreatitis?

A
  1. hypovolemic shock
  2. pancreatic pseudocysts
  3. pancreatic abscess - ecoli
  4. DIC and ARDs
8
Q

What are the most common causes of chronic pancreatitis?

A

alcohol and CF

9
Q

What is the clinical presentation of chronic pancreatitis?

A

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

10
Q

Why arent amylase and lipase good markers for chronic pancreatitis?

A

they are totally destroyed by this point

11
Q

What are some unfortunate complications of chronic pancreatitis?

A

secondary DM

inc risk for pancreatic carcinoma

12
Q

What is the appearance of the pancreas in chronic pancreatitis?

A

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

13
Q

What are the risk factors for pancreatic carcinoma?

A
  1. smoking
  2. chronic pancreatitis
  3. Obesity
  4. DM
14
Q

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

A

kras –> p16 –> p53, BRCA2, DPC4/SMAD4

15
Q

Where is the most common site of pancreatic carcinoma?

A

the head of the pancreas

16
Q

What is a common site of metastasis of pancreatic cancer?

A

the liver

17
Q

Why is persistent pain a common finding in pancreatic carcinoma?

A

perineural invasion

18
Q

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

A

obstructive jaundice with pale stools and palpable GB

19
Q

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

A

secondary DM

20
Q

What is the treatment for pancreatic carcinoma?

A

whipple procedure

removes head and neck, duodenum, GB

21
Q

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

A

sc fat necrosis, polyarthralgia, eosinophilia

all due to hypersecretion of lipase

22
Q

What inc risk for serous cystadenomas?

A

VHL mutation

23
Q

What are the common mutations associated with pNETs?

A

MEN1 and VHL

24
Q

What do pNETs stain positive for?

A

chromogranin A and synaptophysin