Pancreas

Question 1

How much enzymic HCO3- rich fluid does the pancreas produce per day

Answer 1

2L

Question 2

What stimulates the release of enzymic HCO3- rich fluid from the pancreas

Answer 2

Cholecystokinin (CKK)

Secretin

Question 3

What cell produces secretin and where

Answer 3

S-cells in the duodenum

Question 4

What does secretin do

Answer 4

Controls gastric acid secretion and buffering with HCO3-

Question 5

What cell produces CCK and where

Answer 5

I cells in the duodenum

Question 6

What does CCK do

Answer 6

Causes release of digestive enzymes

Responsible for stimulating digestion of protein and fat

Question 7

Vasoactive peptide which stimulates the secretion of H2O into the pancreatic system

Answer 7

D1

Question 8

Criteria for metabolic syndrome

Answer 8

Fasting Hyperglycaemia (>6mmol/l)
Hypertension (>140/90mmHg)
Microalbuminuria 
Central obesity (>94cm M, >80cm F)
Dyslipidaemia (decrease HDL <1mmol/l AND increased TG >2mmol/l)

Question 9

Diagnosis of diabetes mellitus

Answer 9

Fasting plasma glucose = >7mmol/l

Random blood glucose = >11.1 mmol/l

Question 10

Renal complication of diabetes

Answer 10

Glomerulonephritis

Pyelonephritis

Question 11

What scoring scale used for acute pancreatitis

Answer 11

GLASGOW scale

Question 12

What score on Glasgow scale means patient should be referred to ITU

Answer 12

Score of 3 or more

Question 13

I GETSMASHED

Answer 13

Idiopathic
Gallstones 
Ethanol 
Trauma 
Steroids 
Mumps 
Autoimmune
Scorpion venom
Hyperlipidaemia 
ERCP
Drugs e.g. thiazides

Question 14

Most common cause of acute pancreatitis

Answer 14

Gallstones

50% in the U.K. due to this

Question 15

The most common WORLDWIDE cause of acute pancreatitis

Answer 15

Alcohol

Question 16

Drugs which can cause acute pancreatitis

Answer 16

furosemide
didanosine
oestrogens
azathioprine
thiazide diuretics
sulfonamides
tetracyclines
sulindac
mercaptopurine
valproic acid
L-asparaginase

Question 17

Histology of acute pancreatitis

Answer 17

Coagulative necrosis

Question 18

Sensitive test for acute pancreatitis

Answer 18

Serum lipase

Question 19

Most common cause of chronic pancreatitis

Answer 19

Alcohol

Question 20

Causes of chronic pancreatitis

Answer 20

Alcoholism
Hereditary eg CF
Autoimmune eg IgG4 sclerosing
Pancreatic duct obstruction eg stones/tumour

Question 21

Histology of chronic pancreatitis

Answer 21

Fibrosis and loss of exocrine tissue
Duct dilation with secretions
Calcification

Question 22

Acinar cell carcinoma has positive immunoreactivity for

Answer 22

Lipase
Trypsin
Chymotrypsin

Question 23

Histopathology of acinar cell carcinoma

Answer 23

Neoplastic epithelial cells with eosinophilic granular cytoplasm
Positive immunoreactivity for lipase, Tripsin and chymotripsin

Question 24

85% of all pancreatic malignancies

Answer 24

Ductal adenocarcinoma of the pancreas

Question 25

Common location of ductal adenocarcinoma of the pancreas

Answer 25

Head of the pancreas

Question 26

Tumour marker of ductal adenocarcinoma of pancreas

Answer 26

CA 19.9 (>70IU/mL)

Question 27

How are cells arranged in neuroendocrine tumours (islet cell tumours)

Answer 27

Nests or trabeculae with a granular cytoplasm

Question 28

VIPOMA

Answer 28

``` Vasoactive intestinal peptide Neuroendocrine tumour (islet cell tumour) Causes diarrhoea ```

Question 29

Gastrinoma causes

Answer 29

Zollinger Ellison syndrome which causes recurrent ulceration

Question 30

Which MEN has marfanoid phenotype

Answer 30

MEN 2B

Question 31

MEN 1

Answer 31

Parathyroid Pancreatic endocrine tumour (often Phaeo) Pituitary adenoma

Question 32

MEN 2A

Answer 32

Parathyroid Thyroid Phaeo

Question 33

Men2B

Answer 33

Medullary thyroid Phaeo Neuroma Marfanoid phenotype

Question 34

A pancreatic malformation which which can present with duodenal obstruction in a 1 YO

Answer 34

Annular pancreas