Pancreaticobiliary pathology Flashcards Preview

Gastrointestinal > Pancreaticobiliary pathology > Flashcards

Flashcards in Pancreaticobiliary pathology Deck (20):
1

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

Ulcerative colitis

2

90% of all pancreatic tumours are.... ?

Ductal adenocarcinoma

3

What is a pancreatic pseudocyst?

A localised collection of pancreatic secretions
(it is a complication of chronic pancreatitis)

4

How does chronic pancreatitis present?

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

5

What are the 3 main mechanisms causing acute pancreatitis?

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

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

6

How do we diagnose acute pancreatitis?

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

7

What are the symptoms of acute pancreatitis?

Severe epigastric pain
Nausea and vomiting
Peritonitis +/- shock

8

What is pancreatitis caused by?

Enzymatic auto-digestion of pancreatic tissue
(can be acute or chronic)

9

What are the complications of cholecystitis?

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

10

Symptoms of cholecystitis?

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

CHRONIC:
Often asymptomatic or repeated bouts of acute pain.

11

What is cholecystitis?

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

12

Differentiate black vs brown pigment stones

Black- sterile bile
Brown- infected bile

13

What are 20% of gallstones made of?

Pigment stones.
Black or brown stones.

14

What are gallstones?

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

15

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

Chile stasis, jaundice, cholangitis, pancreatitis

16

What percentage of gallstones are symptomatic?

10-20%

17

Causes of raised amylase

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

What is the key biochemical diagnostic test for acute pancreatitis?

Serum amylase

19

Name some causes of acute pancreatitis?

Common: gallstones, alcohol abuse, idiopathic

Less common: hypercalcaemia, hypertriglyceridaemia

20

What is the commonest cause of chronic pancreatitis?

Excess alcohol