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Clinical Pathology > Function of the Pancreas > Flashcards

Function of the Pancreas Flashcards

1
Q

Exocrine functions of the pancreas

A

85%
Glands-ducts-duodenum
Secrete digestive enzymes

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2
Q

Endocrine functions of the pancreas

A

Islets of langerhans

Secrete peptide hormones into the blood (insulin and glucagon)

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3
Q

2 types of pancreatitis

A

Acute and chronic

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4
Q

Clincial features of acute pancreatitis

A

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

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5
Q

Prognosis of acute pancreatitis

A

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

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6
Q

Lab tests for acute pancreatitis

A 
Raised serum amylase/lipase
Hypocalcaemia (fatty acids bind calcium ions)
Hyperglycaemia
Abscess formation
Pseudocysts
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7
Q

Causes of acute pancreatitis

A

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

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8
Q

Mild pancreatitis

A

Swollen gland with fat necrosis

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9
Q

Severe pancreatitis

A

Swollen, necrotic gland with fat necrosis and haemorrhage

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10
Q

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

A

Grey Turner’s sign

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11
Q

Sign to show periumbilicus in acute pancreatitis

A

Cullen’s sign

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12
Q

Complications of acute pancreatitis

A

Shock
Intravascular coagulopathy
Haemorrhage
Pseudocysts

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13
Q

Collections of pancreatic juice secondary to duct rupture

A

Pseudocysts

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14
Q

Chronic pancreatitis

A

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

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15
Q

Chronic pancreatitis is irreversible destruction of which tissue first

A

Exocrine first

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16
Q

Complications of chronic pancreatitis

A

Malnutrition and diabetes

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17
Q

Risk factors for chronic pancreatitis

A 
Toxic- alcohol, smoking
Genetic
Obstruction of the main duct-cancer scarring
Recurrent acute pancreatitis
Autoimmune
Idiopathic
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18
Q

Main genetic mutations associated with chronic pancreatitis

A

CFTR, PRSS1, SPINK1 mutations

19
Q

Clinical presentation of chronic pancreatitis

A

Intermittent abdo pain, back pain and weight loss

20
Q

Histlogy of chronic pancreatitis

A

Can mimic carcinoma macroscopically and microscopically

21
Q

Complications of chronic pancreatitis

A

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

22
Q

Prognosis of chronic pancreatitis

A

Nearly 50% with 20-25 years of disease onset

23
Q

Pathology of chronic pancreatitis

A 
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
Q

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

A

Pancreatic adenocarcinoma (ductal adenocarcinoma)

25
Q

Prognosis of pancreatic cancer

A

5 year survival 4%

26
Q

Risk factor for pancreatic adenocarcinoma

A

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

27
Q

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

A

60-70% head of pancreas

28
Q

Clinical symptoms of pancreatic adenocarcinoma

A

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
Q

Inflammation of the veins because of the blood clots

A

Thrombophlebitis

30
Q

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

A

DNA mismatch repair

31
Q

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

A

BRCA2

32
Q

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

A

ATM

33
Q

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

A

VHL

34
Q

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

A

Cationic trypsinogen, SPINK1

35
Q

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

A

LKB1/STK11

36
Q

second most common pancreatic cancer

A

Pancreatic neuroendocrine tumour

37
Q

What genetic mutations predispose you to pancreatic neuroendocrine tumours?

A

MEN1

Von Hippel Lindau

38
Q

Pancreatic cancer with a specturm of malignancy from benign to malignant

A

Pancreatic neuroendocrine tumour

39
Q

2 types of neuroendocrine tumours

A

Well differentiated

Poorly differentiated

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

Poorly differentiated neuroendocrine carcinomas

41
Q 
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
A

Well-differentiated neuroendocrine tumour

42
Q

Benign pancreati cancer

A

Insulinoma

43
Q

Clinical findings of gastrinoma

A

Peptic ulcer

Diarrhoea

Clinical Pathology (53 decks)

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