Histopathology 7 - Diseases of the pancreas and gall bladder Flashcards Preview

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Flashcards in Histopathology 7 - Diseases of the pancreas and gall bladder Deck (33)
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1

Recall the mnemonic for the causes of acute pancreatitis

I GET SMASHED

Idiopathic

Gallstones
Ethanol
Trauma

Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipidaemia/hypercalcaemia/hyperparathyroidism
ERCP
Drugs

2

Recall two causes of pancreatitis via duct obstruction

Gallstones
Alcohol (via spasm/ oedema of Sphinter of Oddi)

3

Recall the pathophysiology of injury seen in acute pancreatitis

1. Enzymes activated
2. Acinar necrosis
3. Enzyme release

Can cause anything from stromal oedema to haemorrhagic necrosis

4

Why are yellow/white foci seen in acute pancreatitis?

Lipases cause fat necrosis
Calcium ions bind to free fatty acids forming soaps (which are white yellow)

5

What is a pseudocyst?

Dilated space with no epithelial lining

6

What is a cyst?

Dilated space lined by epithelium

7

Recall 2 pancreatic and 3 systemic complications of acute pancreatitis

Pancreatic: pseudocyst + abscess
Systemic: shock, hypoglycaemia, hypocalcaemia

8

Recall 4 complications of chronic pancreatitis

Malabsorption
Diabetes mellitus
Pseudocysts
Carcinoma of the pancreas

9

What is contained within a pancreatic pseudocyst?

Pancreatic enzymes and necrotic material (which is why it's so bad when they perforate - it causes peritonitis)

10

Which immunoglobin is implicated in autoimmune acute pancreatitis?

IgG4

11

What type of cancer makes up 85% of pancreatic neoplasms?

Ductal carcinoma

12

What mutation is very common in ductal carcinoma?

K-Ras

13

What are the 2 types of precancerous dysplastic ductal lesions in the pancreas?

1. PanIn (pancreatic intraductal neoplasm)
2. Intraductal mucinous papillary neoplasm

14

Which type of tumour has a "gritty and grey" macroscopic appearance?

Ductal carcinoma

15

Define adenocarcinoma

Mucin-secreting glands set in desmoplastic stroma (means: strong stromal reaction)

16

Recall 3 complications of ductal carcinoma

1. Liver metastasis
2. Chronic pancreatitis
3. Venous thrombosis ("migratory thrombophlebitis"/ Trousseau syndrome) = mucin activating coagulation in circulatory system causing thrombosis

17

Which type of pancreatic tumours are usually benign?

Cystic tumours

18

Which type of pancreatic tumour is likely to contain neuroendocrine markers?

Pancreatic endocrine neoplasms

19

Recall a neuroendocrine marker in pancreatic endocrine neoplasms

Chromogranin

20

Which type of pancreatic tumour is associated with MEN1?

Pancreatic endocrine neoplasms

21

What is the most common type of secretory pancreatic tumour?

Insulinomas

22

In which portion of the pancreas are neuroendocrine tumours most common?

Tail

23

What are the 2 types of gallstone?

Cholesterol
Pigment

24

What do pigment gallstones contain?

Calcium salts of unconjugated bilirubin

25

Which type of gallstones are radiolucent/radio opaque

Cholesterol: radiolucent
Pigment: radio-opaque

26

Recall 4 potential complications of gallstones

Bile duct obstruction
Cholecystitis
Gall bladder cancer
Pancreatitis

27

What is the most common cause of acute cholecystitis?

Gallstones (accounts for 90%)

28

What is a key histopathological finding in chronic cholecystitis?

Diverticula Rokitansky-Aschoff sinuses

29

What is the most common cause of gallbladder cancer?

Gallstones

30

What are the 3 patterns of injury that may be seen in acute pancreatitis?

Periductal (necrosis of acinar cells near ducts)

Perilobular (necrosis at the edges of lobules)

Panlobular (develops from either of the above)

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