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ARDMS Abdominal Review > Pancreas > Flashcards

Pancreas Flashcards

1
Q

The exocrine function of the pancreas secretes what 3 things

A

1) Trypsin
2) Lipase
3) Amylase

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2
Q

What does the endocrine function of the pancreas secrete

A

Insunlin via the Islets of Langerhams

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3
Q

A normal pancreas should measure how many cm

A

Less than 3 cm

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4
Q

What structure is a nonencapsulated, retroperitoneal structure that lies between the duodenal loop and the splenic hilum

A

Pancreas

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5
Q

An inflammatory disease producing temporary pancreatic changes describes

A

Acute pancreatits

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6
Q

What are the 2 most common causes of acute pancreatitis

A

1) Biliary tract disease

2) Chronic alcohol abuse

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7
Q

What is the sonographic finding associated with acute pancreatitis

A

Enlarged hypoechoic gland

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8
Q

An inflammatory mass formed by edema and leakage of pancreatic enzymes describes

A

Pancreatic phlegmon

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9
Q

A spreading diffuse inflammatory reaction to an infection which forms a suppurative lesion describes

A

Phlegmon

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10
Q

Irreversible destruction by repeated bouts of pancreatic inflammation describes

A

Chronic pancreatits

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11
Q

What is the most common cause of chronic pancreatitis

A

Alcoholism

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12
Q

A small echogenic gland is a sonographic finding of what

A

Chronic pancreatitis

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13
Q

What 2 things are pancreatic cysts associated with

A

1) PKD

2) von Hippel-Lindau syndrome

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14
Q

An exocrine gland disorder resulting in viscous secretions causing pancreatic dysfunction describes

A

Cystic Fibrosis

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15
Q

The accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum describes

A

Pancreatic pseudocysts

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16
Q

The most common reason for pancreatic pseudocyst in children is

A

Abdominal trauma

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17
Q

What is the most common congential variant of pancreatic anatomy

A

Pancreas divisum

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18
Q

What is the mean patient age of pancreatic adenocarcinoma

A

55 years old

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19
Q

What are the 2 most common cystic neoplasms of the pancrease

A

1) Serous cystadenoma

2) Mucinous cystic neoplasms

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20
Q

Serous cystadenoma is associated with

A

von Hippel - Lindau syndrome

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21
Q

On a sonographic image a cluster of grapes is a finding of what pancreatic disease

A

Serous cystadenoma

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22
Q

An increased CEA (carcinoembryonic agent) is associated with what pancreatic disease

A

Mucinous cycstic neoplasm

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23
Q

Islet cell tumors are associated with what type of pancreatic tumor

A

Endocrine

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24
Q

What is the most common Islet cell tumor

A

Insulinoma

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25
Q

What is the 2nd most common Islet cell tumor

A

Gastrinoma (Zollinger-Ellison Syndrome)

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26
Q

What lab value is produced by the pancreas and salivary glands

A

Amylase

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27
Q

What lab value describes a digestive enzyme for carbohydrates

A

Amylase

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28
Q

The head of the pancreas is located where to the IVC

A

Anterior

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29
Q

The head of the pancreas is located where to the 2nd portion of the duodenum

A

Medial

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30
Q

The common bile duct is located where to the head of the pancreas

A

Posterolateral

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31
Q

The gastroduodenal artery is located where to the head of the pancreas

A

Anterolateral

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32
Q

The SMA and SMV are located where to the neck of the pancreas

A

Posterior

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33
Q

The uncinate process is located where to the SMA and SMV

A

Posterior

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34
Q

The aorta is located where in relation to the body of the pancreas

A

Posterior

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35
Q

The celiac axis is located where in relation to the pancreas

A

Superior

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36
Q

The splenic vein is located where in relation to the pancreas

A

Posteriorinferior

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37
Q

The SMA and SMV are located where in relation to the 3rd portion of the duodenum

A

Anterior

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38
Q

The stomach is located where in relation to the pancreas body and tail

A

Anterior

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39
Q

The tail of the pancreas is located where in relation to the stomach

A

Posterior

40
Q

The splenic artery is located where in relation to the pancreas

A

Superior/anterior

41
Q

What is another name for the main pancreatic duct

A

Wirsung’s duct

42
Q

Where does the pancreatic head lie

a) caudad to the portal vein and medial to the superior mesenteric vein
b) cephalad to the portal vein and medial to the superior mesenteric vein
c) caudad to the portal vein and anterior to the inferior vena cava
d) cephalad to the portal vein and anterior to the inferior vena cava

A

C

43
Q

What is the most common location of pancreatic pseudocysts

a) lesser sac
b) porta hepatis area
c) groin
d) splenic hilum
e) mediastinum

A

A

44
Q

Y

A
45
Q

Y

A
46
Q

What 3 lab values are contained in pseudocystts

A

1) Amylase
2) Lipase
3) Trypsin

47
Q

What are the 5 common causes of pancreatic pseudocysts

A

1) Chronic pancreatits
2) Acute pancreatitis
3) Pancreatic trauma
4) Pancreatic ductal obstruction
5) Pancreatic neoplasms

48
Q

An uncommon congenital anomaly where a ring of normal pancreatic tissue encircles the duodenum secondary to abnormal migration of the ventral pancreas is called

A

Annular pancreas

49
Q

Y

A
50
Q

This is the most common Islet cell tumor is usually benign and is hyperinsulinemia

A

Insulinoma

51
Q

This is the 2nd most common Islet cell tumor, is frequently malignant and is associated with gastric acid hypersecretion, gastric and duodenal ulceration

A

Gastrinoma

52
Q

The gastroduodenal artery is a branch of which of the following?

1) aorta
2) celiac axis
3) common hepatic artery
4) left gastric artery
5) duodenal artery

A

3) common hepatic artery- It is a landmark for the anterior lateral aspect of the head of the pancreas

53
Q

If a mass is the area of the pancreatic head is found, what other structure should be examined songraphically

1) the liver
2) the IVC
3) spleen
4) kidney
5) bowel

A

1) Liver-The CBD and main pancreatic duct may be dilated secondary to obstruction caused by enlargement off the mass

54
Q

What is the most common primary carcinoma of the pancreas?

1) insulinoma
2) cystadenocarinoma
3) adenocarinoma
4) pancreatic pseudocyst
5) lymphoma

A

3) adenocarcinoma

55
Q

The common bile duct is joined by the pancreatic duct as they enter the:

1) first portion of the duodenum
2) second portion of the duodenum
3) third portion of the duodenum
4) fourth portion of the duodenum
5) pylorus of the stomach

A

2) 2nd portion of the duodenum

56
Q

The body of the pancreas is bound on its anterior surface by which of the following?

1) atrium of the stomach
2) greater sac
3) splenic vein
4) common bile duct
5) duodenum

A

1) atrium of the stomach

57
Q

Identify the part of the pancreas that lies anterior to the IVC and posterior to the SMV

1) head
2) neck
3) body
4) uncinate process
5) tail

A

4) uncinate process

58
Q

Identify the vessel that is located superior to the pancreas

1) IVC
2) SMA
3) splenic vein
4) celiac axis
5) left renal vein

A

4) celiac axis- orginates within the first 2 cm of the abdominal aorta therefore it is located superior to the pancreas. All of the other vessels listed are used as landmarks for locating and imaging the pancreas

59
Q

The head of the pancreas is located anterior to which of the following vessels

1) IVC
2) aorta
3) SMA
4) splenic vein
5) portal vein

A

1) IVC

60
Q

An abdominal sonogram is performed, and there is a suggestion of a mass in the head of the pancreas. Identify the other structures that should be evaluated.

1) the biliary system and gallbladder to evaluate biliary obstruction
2) the hepatic artery and splenic artery to document dilatation
3) the kidney to evaluate renal obstruction
4) liver to evaluate focal masses
5) spleen to document size

A

1) when there is extrinsic pressure and obstruction of the common bile duct, the gallbladder and biliary tree will be enlarged

61
Q

Islet cell tumors of the pancreas are most likely to be located in which portion of the pancreas

1) head and neck
2) neck and tail
3) uncinate process
4) body and tail
5) head and body

A

4) body and tail- Islet cell tumors of the pancreas are well-circumscribed solid masses with low-level echoes and are frequently found in the body and tail of the pancreas and rarely in the head of the pancreas

62
Q

What is the most common primary neoplasm of the pancreas

1) an adenocarcinoma
2) an insulinoma
3) a pseudocyst
4) a cystadenoma
5) a congenital cyst

A

1) adenocarcinoma

63
Q

What is the most common cause for acute pancreatitis in the United States?

1) smoking and alchol abuse
2) cocaine and marijuana
3) cholelithiasis and pancreatic tumor
4) cholelithaisis and alcoholism
5) peptic ulcer and abdominal trauma

A

4) cholelithasis and alcoholism

64
Q

A 35 year old man presents with right upper quadrant pain and recurrent attacks of pancreatits. His lab values results would be expected to indicate which of the following

1) Increased BUN
2) decreased serum amylase
3) increased lipase
4) increased indirect bilirubin
5) increased alkaline phosphatase

A

3) increaed lipase

65
Q

Obstruction of the CBD by a mass in the head of the pancreas will lead to which of the following?

1) a dilated gallbladder with dilated biliary radicles
2) a contracted gallbladder with dilated biliary radicles
3) dilated biliary radicles with normal or shrunken gallbladder
4) portal hypertention
5) cirrhosis

A

1) a dilated gallbladder with dilated biliary radicles

66
Q

The head of the pancreas is located to the right of which of the following?

1) celiac axis
2) IVC
3) gastroduodenal artery
4) CBD
5) portal splenic confluence

A

5) portal splenic confluence

67
Q

What portion of the pancreas is anterior to the formation of the portal vein?

1) head
2) neck
3) isthmus
4) body
5) tail

A

2) neck

68
Q

The portal vein is the result of the combination of the _____ and the _____

A

SMV and splenic vein

69
Q

Pancreatic adenocarcinoma is songraphically seen as a solid focal hyperechoic mass typically (70%) in the head of the pancreas. What additional findings are associated with pancreatic adenocarcinoma?

A

1) dilated biliary system
2) dilated pancreatic duct
3) Liver mets
4) ascsites
5) lymphadenopathy
6) pseudocyst formation

70
Q

What sign is associated with adenocarcinoma of the pancreatic head resulting in extrinsic compression of the CBD and an enlarged gallbladder

A

Courvoiser sign

71
Q

The pancreas is a nonencapsulated, retroperitoneal structure located between the second portion of the duodenum and the splenic hilum. what space in the retroperitoneum is the pancreas located

A

Located in the anterior pararenal space of the retroperitoneum

72
Q

What are the branches of the celiac axis

A

The celiac axis divides into the left gastric, common hepatic, and splenic arteries

73
Q

What are the branches of the common hepatic artery

A

The common hepatic artery divides into the proper hepatic and the gastroduodenal arteries

74
Q

What 2 veins join to form the MPV

A

1) SMV

2) Splenic vein

75
Q

What are Islet Cell tumors

A

Small, well circumscribed masses, usually found within the pancreatic body and tail

76
Q

Are Islet Cell tumors benign or malignant

A

Although Islet cell tumors are considered the most common benign tumors of the pancreas, they can also be malignant

77
Q

Name the 2 most common Islet cell tumors and describe the symptoms related to each

A

1) Insulinoma- characteriezed by hyperinsulinism and hypoglycemia
2) Gastrinomas- sociated with gastric hypersecretions and peptic ulcer disease (Zollinger-Ellision syndrome)

78
Q

Name 6 tumors associated with Multiple Endocrine Neoplasia Syndrome

A

1) Pituitary adenoma
2) Parathyroid adenoma
3) Medullary thyroid carcinoma
4) Pancreatic Islet cell tumors
5) Pheochromocytoma
6) Ganglioneurmatosis

79
Q

What are pancreatic pseudocysts

A

Collections of pancreatic fluid encapuslated by fibrous tissue

80
Q

What are the 5 causes of pancreatic pseudocyts

A

1) acute pancreatits
2) chronic pancreatitis
3) pancreatic trauma
4) pancreatic neoplasm
5) pancreatic ductual obstruction

81
Q

Name 5 possible locations of pancreatic pseudocysts

A

1) pancreas (most common)
2) Intraperitoneal
3) Retroperitoneal
4) Intraparenchymal (within liver, spleen, and kidney)
5) Thorax (passage through diaphragm)

82
Q

What other name does the main pancreatic duct go by?

a) common bile duct
b) Wirsungs duct
c) hepatic duct
d) duct of Santorini

A

B) Wirsungs Duct

83
Q

What is a tongue like projection at the head of the pancreas

A

Uncinate process

84
Q

The pancreas is found in what retroperitoneal space

a) posterior pararenal
b) perirenal
c) anterior pararenal
d) retrofascial

A

c) anterior pararenal

85
Q

Branches of which of the following vessels supply the pancreas with blood?

a) SMA and right gastric artery
b) proper hepatic artery and SMA
c) GDA and proper hepatic artery
d) SMA and GDA

A

d) SMA and GDA

86
Q

The most common location for the formation of a pancreatic pseudocyst is

a) within the greater sac of the omental layers
b) within the peritoenal cavity
c) within the lesser sac of the omental layers
d) adjacent to the uncinate process

A

c) within the lesser sac of the omental layers

87
Q

What causes pseudopancreatitis

a) fatty liver
b) hepatitis
c) cholecystitis
d) polycystic liver disease

A

a) fatty liver

88
Q

What lab test is used to evaluate the endocrine function of a pancreas transplant

a) amylase levels
b) hematocrit levels
c) anodal trypsinogen levels
d) glucose levels

A

d) glucose levels

89
Q

The______ can be identified anterior to the pancreas tail

a) hepatic flexure of the colon
b) stomach
c) SMA
d) left kidney

A

b) stomach

90
Q

Which abdominal vessel is the best landmark to identify the body and tail of the pancreas

a) left renal vein
b) right renal vein
c) splenic vein
d) superior mesenteric vein

A

c) splenic vein

91
Q

What organ produces sodium bicarbonate

a) adrenal gland
b) parathyroid gland
c) kidneys
d) pancreas

A

d) pancreas

92
Q

The pancreatic tail is anterior to all of the following except

a) splenic hilum
b) upper pole left kidney
c) lesser omental sac
d) left adrenal gland

A

c) lesser omental sac

93
Q

The IVC is located posterior to the pancreatic______

a) tail
b) neck
c) head
d) body

A

c) head

94
Q

Which of the following describes the sonographic appearance of the pancreas with chronic cystic fibrosis

a) increased size with nodule and calcification formation
b) increased size with mottled echogenicity, no definite nodules
c) decreased size and increased overall echogenicity
d) decreased size with hypoechoic nodularity throughout the gland

A

c) decreased size and increased overall echogenicity

95
Q

Which of the following is a common complication of cystic fibrosis

a) meconium ileus
b) portal HTN
c) renal calculi
d) AAA

A

a) meconium ileus

96
Q

A disorder that affects the pancreas by causing it to excrete a thick mucus like substance that inhibits the exocrine function is called

a) tuberculosis
b) cystic fibrosis
c) insulinoma
d) pancreatitis

A

b) cystic fibrosis

97
Q

Which type of pancreatic mass has a strong risk of malignant conversion

a) insulinoma
b) gastrinoma
c) microcystic cystadenoma
d) macrocystic cystadenoma

A

d) macrocystic cystadenom

ARDMS Abdominal Review (14 decks)

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