Pancreaticobiliary pathology Flashcards

1
Q

80% of those with primary sclerosing cholangitis also have what condition?

A

Ulcerative colitis

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2
Q

90% of all pancreatic tumours are…. ?

A

Ductal adenocarcinoma

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3
Q

What is a pancreatic pseudocyst?

A

A localised collection of pancreatic secretions

it is a complication of chronic pancreatitis

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4
Q

How does chronic pancreatitis present?

A

Episodic abdominal pain (recurrent pancreatitis)
Maldigestion
Diabetes Mellitus
Occasional jaundice

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5
Q

What are the 3 main mechanisms causing acute pancreatitis?

A

1) Duct obstruction
2) Acinar cell injury
3) Defective intracellular transport

All of these lead to acinar cell injury and activated enzymes.

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6
Q

How do we diagnose acute pancreatitis?

A

3-4 fold increase in plasma lipase (48hrs) or amylase (24hrs)

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7
Q

What are the symptoms of acute pancreatitis?

A

Severe epigastric pain
Nausea and vomiting
Peritonitis +/- shock

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8
Q

What is pancreatitis caused by?

A

Enzymatic auto-digestion of pancreatic tissue

can be acute or chronic

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9
Q

What are the complications of cholecystitis?

A

Cholangitis, sepsis, abscess formation, peritonitis, infection,
perforation, decompensation of pre-existing disease.

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10
Q

Symptoms of cholecystitis?

A
ACUTE:
Transient RUQ pain
Fever
Rarely jaundice unless duct obstruction
Murphy's sign usually positive.

CHRONIC:
Often asymptomatic or repeated bouts of acute pain.

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11
Q

What is cholecystitis?

A

Acute or chronic inflammation of the gallbladder- 90% associated with gallstones.

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12
Q

Differentiate black vs brown pigment stones

A

Black- sterile bile

Brown- infected bile

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13
Q

What are 20% of gallstones made of?

A

Pigment stones.

Black or brown stones.

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14
Q

What are gallstones?

A

The majority are cholesterol with small amounts of calcium salts +- bilirubin.

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15
Q

What happens if there is a gallstone in the common bile duct?

A

Chile stasis, jaundice, cholangitis, pancreatitis

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16
Q

What percentage of gallstones are symptomatic?

A

10-20%

17
Q

Causes of raised amylase

A
Acute pancreatitis
Other causes of acute abdomen (e.g. Perforated peptic ulcer, ruptured ectopic pregnancy)
Acute kidney failure
DKA
Mumps (salivary amylase)
Macroamylasaemia (inherited)
18
Q

What is the key biochemical diagnostic test for acute pancreatitis?

A

Serum amylase

19
Q

Name some causes of acute pancreatitis?

A

Common: gallstones, alcohol abuse, idiopathic

Less common: hypercalcaemia, hypertriglyceridaemia

20
Q

What is the commonest cause of chronic pancreatitis?

A

Excess alcohol