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Clinical Pathology > Function of the Pancreas > Flashcards

Flashcards in Function of the Pancreas Deck (43):
1

Exocrine functions of the pancreas

85%
Glands-ducts-duodenum
Secrete digestive enzymes

2

Endocrine functions of the pancreas

Islets of langerhans
Secrete peptide hormones into the blood (insulin and glucagon)

3

2 types of pancreatitis

Acute and chronic

4

Clincial features of acute pancreatitis

Emergency
Sudden onset of severe abdo pain radiating to the back
nausea and vomiting

5

Prognosis of acute pancreatitis

May be mild (recovery within 5-7 days) or serious with high mortality

6

Lab tests for acute pancreatitis

Raised serum amylase/lipase
Hypocalcaemia (fatty acids bind calcium ions)
Hyperglycaemia
Abscess formation
Pseudocysts

7

Causes of acute pancreatitis

Gallstones (50%)
Alcohol (25%)
Rare causes (vascular insufficiency, viral infections-mumps, coxsackie B,hypercalcaemia, ERCP)
Idiopathic

8

Mild pancreatitis

Swollen gland with fat necrosis

9

Severe pancreatitis

Swollen, necrotic gland with fat necrosis and haemorrhage

10

Sign indicating haemorrhage into the subcutaneous tissues of the flank in acute pancreatitis

Grey Turner's sign

11

Sign to show periumbilicus in acute pancreatitis

Cullen's sign

12

Complications of acute pancreatitis

Shock
Intravascular coagulopathy
Haemorrhage
Pseudocysts

13

Collections of pancreatic juice secondary to duct rupture

Pseudocysts

14

Chronic pancreatitis

Progressive inflammatory disorder in which parenchyma of pancreas is destroyed and replaced by fibrous tissue.

15

Chronic pancreatitis is irreversible destruction of which tissue first

Exocrine first

16

Complications of chronic pancreatitis

Malnutrition and diabetes

17

Risk factors for chronic pancreatitis

Toxic- alcohol, smoking
Genetic
Obstruction of the main duct-cancer scarring
Recurrent acute pancreatitis
Autoimmune
Idiopathic

18

Main genetic mutations associated with chronic pancreatitis

CFTR, PRSS1, SPINK1 mutations

19

Clinical presentation of chronic pancreatitis

Intermittent abdo pain, back pain and weight loss

20

Histlogy of chronic pancreatitis

Can mimic carcinoma macroscopically and microscopically

21

Complications of chronic pancreatitis

Malabsorption of fat
Diabetes
Pseudocysts
Stenosis of common bile duct/duodenum

22

Prognosis of chronic pancreatitis

Nearly 50% with 20-25 years of disease onset

23

Pathology of chronic pancreatitis

Localised, irregular involvement of the gland early on, later global atrophy
Dilated and distorted ducts
Calculi est in alcohol induced
Fatty replacement
Pseudocyst formation

24

Most common type of pancreatic cancer (up to 90%)

Pancreatic adenocarcinoma (ductal adenocarcinoma)

25

Prognosis of pancreatic cancer

5 year survival 4%

26

Risk factor for pancreatic adenocarcinoma

60-80yrs, rare before 40 years
Men
Smoking
Heavy alcohol intake, diet, obesity, hereditary, chronic pancreatitis

27

Which part of the pancreas is most commonly affected by pancreatic adenocarcinoma?

60-70% head of pancreas

28

Clinical symptoms of pancreatic adenocarcinoma

Non specific symptoms
Epigastric pain, radiating to back
Weight loss, painless jaundice, pruritis and nausea
Trausseau's syndrome (migratory thrombophlebility)
Courvoisier's sign (palpable gallbladder without pain)
Distat metastases
Diabetes

29

Inflammation of the veins because of the blood clots

Thrombophlebitis

30

HNPCC is a hereditary cancer syndrome with a mutation in what gene

DNA mismatch repair

31

Familial breast cancer is a hereditary cancer syndrome with a mutation in what gene

BRCA2

32

Ataxia telangiectasis is a hereditary cancer syndrome with a mutation in what gene

ATM

33

Von Hippel Lindau is a hereditary cancer syndrome with a mutation in what gene

VHL

34

Familial pancreatitis is a hereditary cancer syndrome with a mutation in what gene

Cationic trypsinogen, SPINK1

35

Peutz Jeghers is a hereditary cancer syndrome with a mutation in what gene

LKB1/STK11

36

second most common pancreatic cancer

Pancreatic neuroendocrine tumour

37

What genetic mutations predispose you to pancreatic neuroendocrine tumours?

MEN1
Von Hippel Lindau

38

Pancreatic cancer with a specturm of malignancy from benign to malignant

Pancreatic neuroendocrine tumour

39

2 types of neuroendocrine tumours

Well differentiated
Poorly differentiated

40

Rare
Females
40-75 years
Advanced disease at presentation
Prognosis without treatment 1-2 months, with chemotherapy up to 50 months

Poorly differentiated neuroendocrine carcinomas

41

Uncommon 1-2% all pancreatic neoplasms
Any age, rare in children
7-13% multiple (MEN-1)
15-35% non-functioning
Single tumours often produce multiple hormones but usually single hyperfunctional syndrome

Well-differentiated neuroendocrine tumour

42

Benign pancreati cancer

Insulinoma

43

Clinical findings of gastrinoma

Peptic ulcer
Diarrhoea