Pancreatic pathology Flashcards
(106 cards)
1
Q
Does the endocrine or exocrine pancreas contain islets?
A
Endocrine
2
Q
Does the endocrine or exocrine pancreas contain acinar architecture and ducts?
A
Exocrine
3
Q
Is the pancreas mostly endocrine or exocrine by mass?
A
Exocrine
4
Q
These cells of the pancreas have zymogen granules with proenzymes
Release mediated by high intracellular calcium
A
Acinar cell
5
Q
Acinar cells have zymogen granules with proenzymes, and release is mediated by high levels of this
A
Intracellular calcium
6
Q
This common condition occurs when the ducts of two pancreatic buds remain separate (fail to fuse)
A
Pancreas divisum
7
Q
Is Pancreas divisum symptomatic?
A
Mostly asymptomatic
8
Q
Pancreas divisum patients have a risk of this condition
A
Pancreatitis
9
Q
This rare anomaly occurs with fusion of pancreatic buds and encircling of duodenum
A
Annular pancreas
10
Q
Annular pancreas is an anomaly with fusion of these structures
A
Pancreatic buds and encircling of duodenum
11
Q
When do patients with Annular pancreas usually present?
A
In 1st year of life
(with duodenal obstruction)
12
Q
This pancreas condition usually presents in the first year of life with duodenal obstruction
A
Annular pancreas
13
Q
An infant with post-prandial vomiting (after eating), abdominal distention, and double bubble sign likely has this condition
A
Annular pancreas
14
Q
“Double bubble” sign is when two bubbles are seen in these separate structures
A
Stomach and Proximal duodenum
15
Q
The “double bubble” sign is a gas bubble in the stomach, and a gas bubble in this portion of the duodenum
A
Proximal duodenum
16
Q
In annular pancreas, there will be absence of air distal to this part of the pancreas
A
Proximal pancreas
17
Q
Annular pancreas involves a localized obstruction to this part of the duodenum
A
Proximal duodenum
18
Q
This condition of the pancreas is associated with duodenal atresia, which can cause polyhydramnios
A
Annular pancreas
19
Q
Annular pancreas is associated with this condition, which can cause polyhydramnios
A
Duodenal atresia
20
Q
Acute pancreatitis is pancreatic injury and inflammation from release of this
A
digestive enzymes
21
Q
Acute pancreatitis occurs when there is premature enzyme activation within the pancreas, rather than this
A
Intestine
22
Q
Trypsinogen is activated to this
A
Trypsin
23
Q
In acute pancreatitis, premature enzyme activation within the pancreas leads to autodigestion of pancreatic parenchyma, resulting in this
A
Liquefactive necrosis
24
Q
Omental saponification occurs in this condition
A
Acute pancreatitis
25
What are the two main mechansisms of acute pancreatitis?
Pancreatic duct stasis/obstruction
Acinar cell injury
26
The two mechanisms of this condition are pancreatic duct stasis/obstruction and acinar cell injury
Acute pancreatitis
27
This mechanism of acute pancreatitis can be caused by gallstones or tumors
Pancreatic duct stasis/obstruction
28
This mechanism of acute pancreatitis can be caused by alcohol or toxins
Acinar cell injury
29
The majority of acute pancreatitis cases are due to these two risk factors
Gallstones and alcohol
30
"I GET SMASHED" is a pneumonic describing the causes/associations of this condition
Acute pancreatitis
Iatrogenic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion stings
Hypercalcemia/hypertriglyceridemia
ERCP (endoscopic retrograde cholangiopancreatography)
Drugs
31
Pancreatic edema, necrotic pancreatic acini, and saponification are seen morphologically in this condition
Acute pancreatitis
32
Where is the location of abdominal pain in acute pancreatitis?
Central location (perigastric)
33
Is abdominal pain in acute pancreatitis better or worse when supine?
Worse
34
Abdominal pain in a central location (perigastric), that is worse when supine and radiates to the back, is seen in this condition
Acute pancreatitis
35
This condition will have a >3 fold elevation of amylase and/or lipase
Acute pancreatitis
36
What are the levels of amylase and lipase in acute pancreatitis?
Elevated
(>3 fold increase)
37
This enzyme that is elevated in acute pancreatitis is less specific, and decreases before pancreatitis subsides
Amylase
38
This enzyme that is elevated in acute pancreatitis is only made in the pancreas, and stays elevated for duration
Lipase
39
Parenchymal variable perfusion and necrosis, and peripancreatic fat edema and necrosis are seen radiographically in this condition
Acute pancreatitis
40
Is hypo- or hypercalcemia seen in acute pancreatitis?
Hypocalcemia
41
Is hypo- or hyperglycemia seen in acute pancreatitis?
Hyperglycemia
42
Hypovolemia-increased hematocrit, hypocalcemia, hyperglycemia, and systemic inflammatory syndrome are clinically seen in this condition
Acute pancreatitis
43
This complication of acute pancreatitis is liquefactive necrosis surrounded by fibrous wall
Pseudocyst
44
What are the contents of a pseudocyst?
Necrotic materal; liquefied or granular
45
A cyst that is high in amylase and digestive enzyme is this type
Pseudocyst (seen in acute pancreatitis)
46
Does the wall of a pseudocyst have an epithelial lining?
No
47
The wall of a pseudocyst is made of this
Fibrosis and granulation tissue
48
The Grey turner sign (plank bruising) occurs due to this, which is a complication of acute pancreatitis
Retroperitoneal hemorrhage
49
Cullen sign (periumbilical bruising) is seen in acute pancreatitis due to this complication
Retroperitoneal hemorrhage
50
How does pleural effusion occur with acute pancreatitis?
Edema fluid crosses diaphragm
51
What causes respiratory distress in acute pancreatitis?
Phospholipase (lecithinase activity)
52
This is fibrotic replacement of pancreatic parenchyma, often after multiple episodes of acute pancreatitis
Chronic pancreatitis
53
Is chronic pancreatitis reversible?
No, irreversible
54
End stage chronic pancreatitis includes destruction of these
Islets (endocrine pancreas)
55
Parenchymal calcifications seen on imaging of the pancreas indicate this condition
Chronic pancreatitis
56
Chronic, persistent abdominal pain, that is often precipitated by meals or ethanol, indicate this condition
Also low grade amylase/lipase elevation
Malabsorption, weight loss
Chronic pancreatitis
57
Chronic pancreatitis can cause deficiency of these vitamins
Fat-soluble vitamins (A, D, E, K)
58
Acinar parenchyma replaced with fibrous tissue, as well as a firm, fibrotic pancreas organ with loss of lobular architecture, are seen morphologically in this condition
Chronic pancreatitis
59
Are calcifications seen in acute or chronic pancreatitis?
Chronic
60
This autoimmune type of chronic pancreatitis is IgG4 mediated; multisystem disorder
Type 1
61
This autoimmune type of chronic pancreatitis is limited to the pancreas; not IgG4 mediated
Type 2
62
These two genes are associated with persistent or inappropriate trypsin inactivation, causing chronic pancreatitis
PRSS1 and Spink1
63
PRSS1 and Spink1 cause persistent or inappropriate trypsin inactivation, resulting in this condition
Chronic pancreatitis
64
PRSS1 and Spink1 are associated with chronic pancreatitis because they cause persistent or inappropriate inactivation of this compound
Trypsin
65
Is secondary diabetes a complication of acute or chronic pancreatitis?
Chronic
66
What is the mechanism by which cystic fibrosis causes pancreatitis?
Thick secretions --> duct obstruction
67
Delayed passage of the first stool can indicate this condition due to thick stools
Cystic fibrosis
68
Pancreatic adenocarcinoma arises from this
Ductal epithelium
69
This malignancy of the pancreas arises from ductal epithelium
Pancreatic adenocarcinoma
70
This is the most common pancreatic malignancy
Pancreatic adenocarcinoma
71
This part of the pancreas most commonly has Pancreatic adenocarcinoma
Head > body > tail
72
Chronic alcohol intake, chronic pancreatitis, smoking, and high fat diet are risk factors for this, which is the most common pancreatic malignancy
Pancreatic adenocarcinoma
73
Mutation of this oncogene is most commonly involved in Pancreatic adenocarcinoma
KRAS
74
KRAS oncogene mutations are most common in genetics of this pancreatic malignancy
Pancreatic adenocarcinoma
75
p53, SMAD4, and p16 are tumor suppressors that can be lost in this pancreatic condition
Pancreatic adenocarcinoma
76
Infiltrative glands within abundant desmoplastic stroma, and frequent perineural invasion, are seen morphologically in this condition of the pancreas
Pancreatic adenocarcinoma
77
Painless jaundice, pain that radiates to the back, weight loss, anorexia, depression, and diabetes can be seen clinically in this condition
Pancreatic adenocarcinoma
78
This condition is migratory thrombophlebitis (blood clots) that can be seen clinically in Pancreatic adenocarcinoma
Trousseau syndrome
79
Troussea syndrome (migratory thrombophlebitis) can be seen in this pancreatic malignancy
Pancreatic adenocarcinoma
80
This is a tumor marker used to follow Pancreatic adenocarcinoma; is NOT used for screening
Ca 19-9
81
Ca 19-9 is a tumor marker used to follow this pancreas disease
Is not used for screening
Pancreatic adenocarcinoma
82
Ampullary adenocarcinoma (of Ampulla of Vater) has divergent differentiation of these two tissue types
Intestinal
Pancreato-biliary
83
Congenital pancreatic cysts can be microscopic to this size
5 cm
84
Congenital pancreatic cysts are lined by this type of epithelium
Cuboidal
85
Elevated intracystic pressure from secretions may flatten epithelium in this anomaly
Congenital pancreatic cysts
86
Cysts in polycystic kidney diseases are possible but less likely in the pancreas, and are lined by this type of epithelium
Simple layer of cuboidal or compressed epithelium
87
This is the most common cyst of the pancreas
Pseudocyst
88
Benign neoplasm with VHL (von Hippel Lindau gene) mutations and bland serous cysts
Serous cystadenoma
89
Serous cystadenoma is a benign neoplasm with gland serous cysts, and mutations in this gene
VHL (von Hippel Lindau gene)
90
Are males or females more likely to have Serous cystadenoma?
Females
(>50 years old usually)
91
This is a precursor lesion to mucinous adenocarcinoma
(1/3 malignant, 2/3 benign)
Mucinous cystic neoplasm
92
Mucinous cystic neoplasm involves mutations in this
KRAS
93
Is Mucinous cystic neoplasm more common in males or females?
Almost always women
94
Mucinous cystic neoplasm is most common in this part of the pancreas
Body or tail
95
Is Mucinous cystic neoplasm connected to the ductal system?
NO
96
This precursor lesion to mucinous adenocarcinoma is almost always women, most common in body or tail of pancreas, and not connected to ductal system
Mucinous cystic neoplasm
97
This precursor lesion to mucinous adenocarcinoma is more common in men, arises in head of pancreas, and grows within or connected to ductal system
Intraductal papillary mucinous cystic neoplasm (IPMN)
98
Is Intraductal papillary mucinous cystic neoplasm (IPMN) more common in males or females?
Men
99
Intraductal papillary mucinous cystic neoplasm (IPMN) arises in this part of the pancreas
Head
100
Does Intraductal papillary mucinous cystic neoplasm (IPMN) grow within the ductal system?
YES - within or connected to
101
Intraductal papillary mucinous cystic neoplasm (IPMN) has abundant production of this
Mucin
102
This precursor lesion to mucinous adenocarcinoma has abundant mucin production
Intraductal papillary mucinous cystic neoplasm (IPMN)
103
Solid pseudopapillary tumors are mostly in this age group and gender
Adolescent / young adult females
104
Are Solid pseudopapillary tumors sympomatic?
Asymptomatic or mild abdominal discomfort
105
In Solid pseudopapillary tumors, epithelial cells adhere to this
Vessels
(remainder of tumor expands producing a papillary appearance)
106
This tumor involves epithelial cells adhering to vessels, and the remainder of the tumor expands producing a papillary appearance
Solid pseudopapillary tumors
