Exocrine Pancreas Pathology

Question 1

What are the top Metabolic Etiologies of Acute pancreatitis?

Answer 1

ALCOHOLISM
Hyperlipoproteinemia
Hypercalcemia
Drugs
Genetic

Question 2

What are the top Mechanical Etiologies of Acute pancreatitis?

Answer 2

Galstones
Trauma
Iatrogenic Injury
-Perioperative
-Endoscopic Pocedres with dye injection

Question 3

What are the top Vascular Etiologies of Acute pancreatitis?

Answer 3

Schock
Atheroembolism
Vasculitis

Question 4

What are the top Infectious Etiologies of Acute pancreatitis?

Answer 4

Mumps
Coxsackievirus
Mycoplasma Pneumoniae

Question 5

What Pancreatic Enzymes are released that cause pathology in pancreatitis?

Answer 5

Proteases(Proteolysis)
Lipase (Fat Necrosis)
Phospholipase
ELastase(hemorrhage)

Question 6

What is the most diagnostic enzyme secreted by the pancreas?

Answer 6

Pancreatic Lipase

Question 7

Where does pancreatitis refer pain to?

Answer 7

Acute Epigastric Pain

Mid Back

Question 8

What is the main difference between Serum Lipase and Amylase?

Answer 8

Amylase peaks sooner

Lipase lasts longer (7-14 days)

Question 9

Waht are the aspects of pancreatitis that are responsible for its high mortality?

Answer 9

Acute Pain, Shock, ARDS, Hypocalcemia

Question 10

What versions of Pancrreatitis are most serious?

Answer 10

Acute Necrotizing p. Bad
Hemmhoragic p. Bad
Acute Interstitial p.

Question 11

What is so bad about Nec. Panc and Hem. Panc.?

Answer 11

Inflammatory Mediators, and activated enzymes

• leukocytosis
• DIC
• fluid sequestration
• diffuse fat necrosis
• ARDS
• SHOCK and ACUTE TUBULAR NECROSIS
• vasoactivators => Vasodilation=> Dec BP

Question 12

Sequelea of Acute Pancreatitis

Answer 12

Sterile abcess
Pseudocyst-Collection of blood, debris, tissue, fluid
infected Pancreatic Necrosis

Question 13

What cellular markers are released in chronic pancreatitis?

Answer 13

TGFBeta
PDGF
Collagen secretion ECM Growth Factor

Question 14

What is the main change in the pancreas caused by chronic pancreatitis

Answer 14

Diffuse Fibrosis and decrease in glandular activity.

Question 15

What mutations are causes of chronic Pancreatitis?

Answer 15

PRSS1 and SPINK1

Question 16

What is the most common cause of Chron Panc at a young age?

Answer 16

Cystic Fibrosis (CFTR gene mutation)

Question 17

What is the most common cause of Chron Panc?

Answer 17

Alcohol abuse
Idiopathic
Gallstones

Question 18

Waht is the cellular morphology of Chronic Pancreatitis?

Answer 18

Acinar cell Drop out
Chronic Inflammatory infiltrate
Marked Fibrosis
Protein Precipitates

Question 19

What is the classical triad of progressive inflammatory disease of the pancreas?

Answer 19

Diabetes
Steatorrhea
Calcifications

also permanent impairment of function
Irreversible morphologic changes

Question 20

Where is the mutation associated with Von Hipple Lindau Syndrome

Answer 20

Chromosome 3

Question 21

What is the congenital disorder that leads to cysts in the pancreas, liver, and kidneys.

Answer 21

Von-Hippel-Lindau Syndrome

Question 22

What are the different types of Cystic Tumors?

Answer 22

Microcystic serous cystadenoma
Mucinous cystic tumors
Solid Pseudopapillary Tumor
Intraductal Pappillary Mucinous neoplasms

Question 23

What is the danger of Intraductal Pappillary Mucinous neoplasms?

Answer 23

They can grow and obstruct the pancreatic ducts and eventually become cancerous

Question 24

What is the difficulty with diagnosing Pancreatic cancer?

Answer 24

None of the symptoms are specific to the pancreas?

Question 25

What gene does smoking stimulate to cause pancreatic cancer?

Answer 25

K-Ras

Question 26

What is the biggest environemental risk factor for pancreatic cancer?

Answer 26

Smoking

Question 27

Where is the most common place for Pancreatic cancer to arise?

Answer 27

In the head of the pancreas(60%)

Question 28

Where is the most common site of mets of Panc. Cancer?

Answer 28

Liver lung peritoneum

Question 29

What demographic has Gallstones more often?

Answer 29

Native Americans Mexicans Northern Europe N/S America

Question 30

What is Accretion?

Answer 30

The formation of a Gallstone

Question 31

What causes Pigmented Gallstones?

Answer 31

Chronic Hemolytic Syndrome BT infection Ileal Disease Ca Precipitation of Bili

Question 32

What causes Cholesterolosis/ strawberry gallblader?

Answer 32

High Cholesterol Diet or hyperlipidemia

Question 33

What causes Chronic Cholecystitis?

Answer 33

Long standing inflammation of the GB Accumulated damage of Acute attacks Chronic infection

Question 34

What is the appearance of Chronic Cholecystitis?

Answer 34

Thickenign of the GB wall and infiltration of inflammatory cells

Question 35

What are the complications of Cholecystitis?

Answer 35

Bacterial Superinfection GB Perforation Abcess GB rupture and Peritonitis Biliary eteric fistula-gallstone induced intestinal obstruction