Pancreas II: Cystic Fibrosis, Cystic Disorders, and Pancreatic Cancer Flashcards Preview

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Flashcards in Pancreas II: Cystic Fibrosis, Cystic Disorders, and Pancreatic Cancer Deck (25):
1

3 main symptoms of CF

**Lung Infections/obstruction/infalmmation
**Chronic Pancreatitis
**Hypertonic Sweat
Heptobilliary tract dz
Meconium ileus in infants
infertility

2

genetic mutation causeing CF

three base pair deletion (∆DF508) that results in defective folding and processing of CFTR Cl- channel

3

CFTR is a (IP3 or cAMP) activated Cl- channel

cAMP

4

what is the pathophys of CF

defective CFTR Cl channel → defefctive Cl- secretion → thickening of secretions → obstruction of ducts and lumens → infection, inflammation and tissue destruction

5

acini in CF are

atrophic

6

gross changes to pancreas in CF

replacement of exocine portion of pancreas with FAT

7

What clinical symptoms diagnose CF

frequent pulm infections (pseudomonas)
Diarrhea, malasb (steatorrhea), and failure to thrive
Dehydration (freq episones)

8

testing used to diagnose CF

sweat Cl- test
PFTs
Genetic Testing

9

How is CF managed

Daily Pulm Toilet/Inhalers that loosen secretions
high dose pancreatic enzymes
treat pulm infections

10

what is the pathophys of the failure to thrive seen in CF?

no acinar cells = no pancreatic digestive enzymes

11

most common cyst-like lesion in the pancrease

pseudocyst

12

In general, of the neoplastic cysts __ _have very little malignant potential while ___ have malignant potential

serous = not malignant
mucinous = malignant

13

what are 4 examples of cystic neoplasms of the pancreas. which are benign and malignant?

Benign:
Serious cystic tumors

Malignant:
Mucinous Cyst neoplasms
Intraductal Papillary mucinous neoplasms
solid pseudopapillary Neoplasms

14

CEA is a tumor marker for

mucinous cystic neoplasm

15

ERCP is a tumor marker for

intraductal papillary mucinous neoplasms

16

common presentation of pancreatic cancer

weight loss, abdominal pain, jaundice

17

90% of pancreatic cancers are

ductal adenocarcinomas

18

What are the miscellaneous pancreatic cancers that account for the other 10%

cystic neoplasms
acinar cell neoplasms
lymphomas and sarcomas
neuroendocrine tumors (gastrinoma, insulinomas, glucagonomas)

19

not going into the histology

nichols made it sound like even pathologists struggle with it

20

Risk factors for pancreatic cancer

smoking
alcohol in the setting on chronic pancreatitis
hereditary pancreatitis
family history of pancreatic cancer

21

What is the tumor marker for pancreatic adenocarcinoma

CA19-9 **DUCTAL cell tumor marker

22

pathophys of jaundice in pancreatic adenocarcinoma

obstruction of CBD

23

What clinical presentation is a clue that the pt may have a mass in the head of their pancreas

painless jaundice
**60-70% of pancreatic adenocarcinomas are in the head of the pancreas

24

what surgical options can cure some pancreatic cancers?

distal pancreatectomy (tail lesions)
Whipple resection (for head lesions)

**chemo and radiation have limited effectiveness therefore surgery is the only chance for a cure

25

what is the best prognostic factor for pancreatic cancers

retroperitoneal resection margin
**only for resectable adenocarcinomas in the head of the pancreas