Pancreas

Question 1

Role of the Pancreas?

Answer 1

produces 2L of enzymic HCO3 rich fluid, stimualted by secretin and CCK

Question 2

where is Secretin made and what does it do?

Answer 2

Produced by s-cells of the duodenum

Controls gastric acid secretion and buffering with HCO3

Question 3

Where is CCK produced and what does it do?

Answer 3

Made by I-cells in the duodenum.

Causes release of digestive enzumes

Question 4

Islet of Langerhans - Alpha cells, what do they secrete and what does that do?

Answer 4

Glucagon, increases blood glucose

Question 5

Islet of Langerhans - Beta cells, what do they secrete and what does that do?

Answer 5

Insulin, decreases blood glucose

Question 6

Islet of Langerhans - Delta cells, what do they secrete and what does that do?

Answer 6

Somatostatin, regulates alpha and beta cells

Question 7

Islet of Langerhans - D1, what does it do?

Answer 7

A vasoactive peptide, stimulates the secretion of H20 into pancreatic system

Question 8

Diabetes - Fasting plasma glucose?

Answer 8

greater than 7mmol/L

Question 9

Diabetes - Random plasma glucose

Answer 9

greater than 11.1mmol/L

Question 10

Acute Pancreatitis - Causes

Answer 10

I GET SMASHED

Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion venom
Hyperlipidaemia
ERCP
Drugs - thiazides

Question 11

Acute Pancreatits - Presentation

Answer 11

Severe epigastric pain radiating to the back, relieved by sitting forward

Question 12

Pancreatic Carcinoma - Epidemology

Answer 12

60 years old, more men than women

Question 13

Pancreatic Carcinoma - Site?

Answer 13

Normally head of the pancreas

Question 14

Pancreatic Carcinoma - Clinical features

Answer 14

Weight loss
Upper abdominal and back pain
Painless jaundice
Trousseau’s syndrome (vessel inflammation - tender, palpable nodules. NOT Trousseau’s sign)
Ascites
Virchow’s node (left supraclavicular fossa)
Courvoisier’s sign (painless jaundice and an enlarged gallbladder = unlikely to be gallstones)

Question 15

Neuroendocrine tumours (Islet cell tumours)

Answer 15

cells arranged in nests or trabeculae with granular cytoplasm
can be functional or non-functional tumours
-functional - presents with sumptoms related to hormone excess
–insulinoma - hypoglycaemic attacks
–Gastrinoma - Zollinger-Ellison syndome (high acid output) = recurrent ulcerations
-Non-Functional -picked up incidentally

Question 16

Multiple Endocrine Neoplasia - what is it? types?

Answer 16

A group of genetic syndromes where there are functioning hormone producing tumours in multiple organs
MEN1 = PPP - Parathyroid hyperplasia, Pancreatic endocrine tumour, Pituitary Adenoma
MEN2A = PPT - Parathyroid, Phaeo, Thyroid
MEN2B = Meduallary thyroid, Phaeo, Neuroma (Marfanoid Phenotype)