Pancreas, Biliary Tract, Liver and Spleen Flashcards
(54 cards)
In annular pancreas, a band of pancreatic tissue encircles what part of the GI tract? What is it associated with?
second part of the Duodenum
Down Syndrome, duodenal stenosis or atresia
What are Ranson’s criteria?
WALLS FOr CHUB admission: WBC > 18 Age > 70 LDH > 400 Liver enzyme (AST) > 250 Sugar > 220
after 48 hours:
Fluid requirement
Oxygen < 60
Calcium < 8
Hematocrit fall > 10%
Urea increase > 5 mg/dL
Base deficit > 5mEq/L
_________ should be suspected in a patient with a history of liver trauma who later develops GI bleeding and abdominal pain.
Hemobilia
What is Felty’s syndrome?
rheumatoid arthritis, swollen spleen, decreased WBC
T/F: Percutaneous needle biopsy is contraindicated in hepatic hemangiomas and adenomas.
True
What is Pringle’s maneuver?
Occlusion of the porta hepatitis: portal vein, hepatic artery, and CBD. Used to control bleeding in hepatic procedures
What is the difference between class I, II, and III injuries to the spleen?
I = nonexpanding hematoma covering less than 10% of spleen
II = parcenchyma 1-3mm deep affectd
III major parenchymal injury
Continuous secretory diarrhea (even when not eating or with continuous NGT suctioning) and hypokalemia:
VIPoma (WDHA)
Migratory necrotizing dermatitis is associated with:
glucagonoma
T/F: Unlike in VIPoma, when you stop eating with ZES, your secretory diarrhea will stop.
True
What is the inheritance pattern of all of the MEN syndromes?
Autosomal dominant
MENI: parathyroid, pancreatic, pituitary tumors
MENIIa: medullary cancer of thyroid, pheo, hyperparathyroidism
MENIIb: medullary cancer of thyroid, pheo, neuromas/Marfanoid
What is the inheritance pattern of hereditary spherocytosis? What is the only treatment?
autosomal dominant; splenectomy
Target cells are indicative of
thalassemia
An anechoic area in hepatic ultrasound is suggestive of
benign liver cysts
T/F: Benign liver cysts and hydatid cysts are more common in the right lobe of the liver.
True
Why might amylase be normal in pancreatitis even if lipase is elevated?
Hyperlipidemia interferes with the chemical determination of amylase
T/F: If a large pseudocyst is present, it might cause anterior displacement of the stomach, transverse colon, or duodenum.
True
Smooth tapering of the CBD on cholangiogram may indicate
pancreatitis or biliary obstruction in pancreatitis
How might chronic pancreatitis lead to jaundice?
1) fibrosis compresses the CBD
2) pseudocysts
3) carcinoma of the head of the pancreas
Why is atelectasis related to pancreatitis?
The pancreas releases a factor that alters pulmonary surfactant
What does a Whipple entail?
pancreaticojejunostomy, gastrojejunostomy, and hepaticojejunostomy; cholecystectomy, and possible bilateral truncal vagotomy (but not if distal stomach and pylorus can be preserved)
When is a stent placed for pancreatic cancer?
Palliative care
A ratio of plasma insulin to glucose of greater than ____ is diagnostic of insulinoma.
> 0.3
T/F: Both CCK and vagal stimulation result in release of fluid with a high concentration of enzymes
True
