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Flashcards in Pancreatic Problems Deck (25)
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1
Q

What is the exocrine function of the pancreas?

A

acinar cells secrete pancreatic enzymes

2
Q

What is the endocrine function of the pancreas?

A

Islets of Langerhans secrete hormones into the blood

3
Q

Which hormones do which Islets of Langerhans secrete?

A

beta - insulin
alpha - glucagon
delta - samatostatin
F cells

4
Q

What pancreatic enzymes do acinar cells secrete?

A

protease (trypsin and chymotrypsin)
pancreatic amylase
pancreatic lipase

5
Q

What do epithelial cells lining the duct produce?

A

bicarbonate

water

6
Q

What are the possible physiological causes of pancreatitis?

A

bile reflux into pancreas cause gallstones
hyperstimulation of pancreatic acinar cells with cholecytokinin
activated enzymes autodigest pancreas

7
Q

What are the classic stomach clinical signs of pancreatitis?

A

Cullens sign
Erythema Abigne
Gray Turners sign

8
Q

What does a CRP of over 150 on admission indicate?

A

severe pancreatitis

9
Q

What are CXR complications of pancreatitis?

A

pleural effusions

sentinel loop

10
Q

What is an abnormal bile duct size?

A

greater than 1cm

11
Q

What criteria is used for pancreatitis? What is severe?

A

Glasgow Criteria
More than 3 is severe

Ransons is less used

12
Q

How is pancreatitis managed?

A

IV fluids

antibiotics and oxygen

13
Q

What is a pancreatic pseudocyst?

A

complication of acute and chronic pancreatitis
causes biliary and gastric outlet obstruction

Treatment: endoscopic drainage

14
Q

Describe chronic pancreatitis?

A

loss of exocrine and endocrine function

progressive and irreversible damage

15
Q

What are the genetic predisposing factors of chronic pancreatitis?

A

Cystic fibrosis

alpha 1-antitrypsin

16
Q

What is the managemetn of chronic pancreatitis?

A

Creon as enzyme replacement therapy if pancreatic insufficiency
Surgery - frey and putsow procedure

17
Q

What are the complications of chronic pancreatitis?

A
Ascites
Pancreatic cancer
Pleural effusions
Psuedocysts 
Psudoaneurysm
Splenic vein thrombosis 
Duodenal obstruction
Biliary obstruction
18
Q

What are the exocrine pancreatic tumours?

A

adenocarcinoma - most common

19
Q

What are the endocrine pancreatic tumours?

A

gastrinoma
insulinoma
glucagonoma

20
Q

What are the risk factors for pancreatic cancer?

A

Type 1 and 2 diabetes
Smoking
Charred meat
Obesity

21
Q

What are the investigations for pancreatic cancer?

A

Ultrasound
CT
MRI and MRCP

22
Q

What is the management of an inoperable case of pancreatic cancer?

A

decompression of obstructed biliary ducts

ERCP or PTC and stent insertion

23
Q

What is the management of an operable case of pancreatic cancer?

A

laparoscopy and staging
ERCP stent
resection or bypass

24
Q

How is pancreatic staging done?

A

Laprascopy

25
Q

What are the resection options for pancreatic cancer?

A

Whipples procedure
Distal pancreatectomy
Total pancreatectomy

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