Pancreas

Question 1

The most common congenital anomaly of the pancreas.

Answer 1

Pancreas divisum

Question 2

Duct of wirsung arises from what bud

Answer 2

Small ventral bud

Question 3

Uncinate process arises from what bud

Answer 3

Small ventral bud

Question 4

Duct of santorini arises from what bud

Answer 4

Dorsal bud

Question 5

Pancreatic body and tail and superior portion of the head arise from what bud

Answer 5

Dorsal bud

Question 6

Treatment of pancreatic divisum.

Answer 6

sphincterotomy and cholecystectomy

Question 7

Treatment of annular pancreas.

Answer 7

duodenojejunostomy

Question 8

Failure of the ventral bud to rotate

Answer 8

Annular pancreas

Question 9

Blood supply to the head of pancreas

Answer 9

SMA and Gastroduodenal artery

Question 10

Blood supply to body of pancreas

Answer 10

Splenic artery

Question 11

Superior venous drainage of pancreas drains into? Inferior drains into?

Answer 11

PV; IMV

Body and tail - splenic vein

Question 12

Pancreas secretes how much pancreatic fluid daily

Answer 12

500-1500 mL

Question 13

Flank ecchymosis [Grey-Turner’s sign] and periumbilical ecchymosis [Cullen’s sign] are seen in

Answer 13

Acute pancreatitis

Retroperitoneal bleeding

Question 14

Confirmatory diagnosis for acute pancreatitis

Answer 14

Contrast abdominal CT

Question 15

Contrast-enhanced abdominal CT finding: Peripancreatic fat stranding, fluid collections, and non-enhancing pancreatic parenchyma with gas

Answer 15

Acute pancreatitis

Question 16

A way to predict morbidity and mortality in patients admitted with acute pancreatitis

Answer 16

Ranson’s criteria

And APACHE II

Question 17

Prophylactic antibiotic for necrotizing pancreatitis

Answer 17

Imipenem

Question 18

CT scan reveal a dilated, calcified pancreatic duct with areas of stenosis (ie, “chain of lakes” appearance).

Answer 18

Chronic pancreatitis

Question 19

The gold standard for the diagnosis of chronic pancreatitis

Answer 19

ERCP

irregular main duct, ductal dilation, and duct strictures.

Question 20

Surgical procedure of choice for chronic pancreatitis with duct of normal diamete

Answer 20

Pancreaticoduodenectomy (Whipple)

Question 21

Surgical procedure of choice for chronic pancreatitis dilated duct

Answer 21

Longitudinal pancreaticojejunostomy (Puestow)

Question 22

Surgical procedure of choice for chronic pancreatitis with distal disease

Answer 22

Distal pancreatectomy

Question 23

Surgical procedure of choice for chronic pancreatitis with small duct with diffuse disease

Answer 23

Total pancreatectomy with autotransplantation of islet cells

Question 24

Peripancreatic fluid collections with a nonepithelialized capsule.

Answer 24

Pseudocyst

Complication of chronic pancreatitis

Persistent abdominal pain and early satiety

Question 25

Imaging of choice for pancreatic pseudocyst

Answer 25

MRI

Question 26

Pancreatic pseudocysts are most commonly associated with

Answer 26

alcoholic pancreatitis

Question 27

Characterized by mucin production, dilation of the pancreatic duct, and communication with the main pancreatic duct.

Answer 27

Intraductal papillary mucinous neoplasms (IPMNs) Head of pancreas

Question 28

Cystic neoplasm of pancreas that are commonly found in middle-aged females and in the body or tail of the pancreas and characterized by an ovarian-like stroma and a lack of ductal communication.

Answer 28

Mucinouscystic neoplasms (MCNs) Distal pancreatectomy

Question 29

Classic presentation of pancreatic ductal adenocarcinoma

Answer 29

Painless jaundice

Question 30

Palpable gallbladder: what sign?

Answer 30

Courvosier's sign

Question 31

Palpable periumbilical metastatic disease

Answer 31

Sister Mary Joseph’s node

Question 32

Migratory thrombophlebitis

Answer 32

Trousseau’s sign

Question 33

Palpable metastases on rectal examination

Answer 33

Blumer’s shelf

Question 34

Elevated marker in pancreatic ductal adenocarcinoma

Answer 34

CA 19-9 and CEA

Question 35

ERCP finding of double duct sign with two strictures

Answer 35

Pancreatic ductal adenocarcinoma CBD and pancreatic duct dilatation

Question 36

Chemoradiotherapeutic regimens for pancreatic cancer

Answer 36

gemcitabine, 5-fluorouracil

Question 37

ERCP finding of double duct sign with one stricture

Answer 37

Ampullary cancer

Question 38

Tumors of what part of the pancreas are usually not detected at an early stage and are usually unresectable at time of diagnosis?

Answer 38

body and tail

Question 39

5 year survival rate of pancreatic cancer

Answer 39

10-20%

Question 40

Whipple's triad is seen in

Answer 40

Insulinoma

Question 41

Migratory necrolytic erythema, anemia, DM, protein malnutrition, hypercoagulability and stomatitis are symptoms of

Answer 41

Glucagonoma

Question 42

Watery diarrhea, hypokalemia, achlorrhydia and hypercalcemia are SSx of

Answer 42

VIPoma or Verner-Morrison syndrome WDHA syndrome

Question 43

Preoperative medication for insulinoma to prevent hypoglycemia

Answer 43

Diazoxide

Question 44

Treatment for small insulinoma (

Answer 44

Enucleation

Question 45

Boundaries of the gastrinoma triangle

Answer 45

(1) Cystic duct (2) Junction of the second and third portions of the duodenum (3) Junction of the neck and body of the pancreas

Question 46

A 50-year-old male with a history of chronic pancreatitis presents with bleeding gastric varices. What is the most likely cause? Curative treatment?

Answer 46

Most likely diagnosis is splenic vein thrombosis. As patient is bleeding, treat with splenectomy.

Question 47

What is the most common location of an insulinoma? Gastrinoma? Glucagonoma? Somatostatinoma?

Answer 47

Insulinoma: Evenly distributed throughout the pancreas. Gastrinoma: Gastrinoma triangle. Glucagonoma: Pancreatic tail. Somatostatinoma: head

Question 48

A 65-year-old man presents with painless jaundice, and you suspect PDAC. What is the most sensitive radiographic modality to diagnosis PDAC?

Answer 48

Endoscopic ultrasound