pathology of the pancreas

Question 1

the most common causes of acute pancreatitis is ___ tract disease and excessive ___ ____

Answer 1

Billiary
alcohol intake

Question 2

____ ___ is acute inflammation of the pancreas

Answer 2

acute pancreatitis

Question 3

with acute pancreatitis there is elevated
- blood and urine ______
- blood _____
- ___ count
- ______

Answer 3

amylase
lipase
WBC
bilirubin

Question 4

in acute pancreatitis blood and urinary amylase are elevated within first ____ hours and stays elevated for __-___ hours

Answer 4

24
48-72

Question 5

with acute pancreatitis blood lipase elevated within ___-___ hours and stays elevated ___-___ days

Answer 5

48-72 hrs
5-14 days

Question 6

some signs and symptoms of ACUTE pancreatitis are
- severe ___ pain which radiates to back ( after large meal or alcoholic Bev)
- nausea and vomiting
- ____
- abdominal ____
- fever
- _____
- history of gallstones and ____ abuse

Answer 6

epigastric
malaise
abdominal DISTENTION
jaundice
ALCOHOL abuse

Question 7

on ultrasound ACUTE pancreatitis in the early stage may appear ____.
late stage shows an enlarged, ____echoic pancreas with possible pancreatic duct diation .
peripancreatic fluid collection with possible ____.
doppler shows ___ blood flow .
the gallbladder wall may be _____

Answer 7

normal
HYPOechoic
ascites
increased
thickened

Question 8

there are 2 forms of ACUTE pancreatitis ____ form and ____ form

Answer 8

edematous
necrotizing

Question 9

the most common form on pancreatitis is ____ form

Answer 9

edematous

Question 10

some complications of ACUTE pancreatitis are
- ____ formation
- _____
- abscess
- _____
- duodenal _____

Answer 10

pseudocyst
phlegmon
hemorrhage
obstruction

Question 11

pancreatic pseudocyst develops __-___ weeks onset of pancreatitis

Answer 11

4-6

Question 12

the most common location for a pancreatic pseudocyst is the ___ sac anterior to the pancreas and ___ to the stomach.
The second most common location is in the anterior ___ space

Answer 12

lesser
posterior
pararenal

Question 13

___ is used as a guidance modality in the approach to precutaneus drainage of pancreatic pseudocyst and abscess

Answer 13

ultrasound

Question 14

for surgical or precutaneus intervention __ to ___ weeks is considered appropriate because by that time the walls of the pseudocyst are relatively well formed and the chances for spontaneous regression have diminished

Answer 14

five to six

Question 15

pancreatic pseudocyst more common location is in the ___ ___

Answer 15

lesser sac

Question 16

pancreatic pseudocyst second most common location is in the ___ ___ ___

Answer 16

anterior pararenal space

Question 17

some complications with pancreatic pseudocyst are
- ____, infection and ____ rupture

Answer 17

bleeding
spontaneous

Question 18

the most common complication of a pancreatic pseudocyst is ___ ___

Answer 18

spontaneous rupture

Question 19

a spontaneous rupture clinical symptoms are sudden shock and ___, mortality rate is __% and pancreatic ____

Answer 19

peritonitis
50%
ascities

Question 20

a complication of ACUTE pancreatitis is pancreatic ___ which is localized suppurative pus collecting in or around the gland

Answer 20

abscess

Question 21

____ causes localized areas of diffused inflammatory edema or soft tissue.
its an inflammatory process that spreads along the fascial pathways

Answer 21

phlegmon

Question 22

phlegmon may progress to ___ and suppuration. usually involves the __ sac, left anterior ___ space and transverse mesocolon.
occurs in 18-20% of patients with ___ ____

Answer 22

necrosis
lesser
pararenal
acute pancreatitis

Question 23

phlegmon on ultrasound appears ___ texture with good through transmission

Answer 23

hypo echoic

Question 24

____ pancreatitis is inflammatory reaction that spreads to the soft tissue surrounding the pancreas, along the fascial pathways producing edema and swelling

Answer 24

phlegmonous

Question 25

a pancreatic ___ is imaged with sonography with poorly defined hypoechic mass with smooth or irregular thick walls causing few internal echoes

Answer 25

abscess

Question 26

_____ pancreatitis is caused by a sudden escape of pancreatic enzymes into the parenchyma causing focal areas of fat necrosis in and around the pancreas which leads to rupture of the vessels and ____

Answer 26

hemmorhagic hemorrhage

Question 27

hemorrhagic pancreatitis is a rapid progression of ____ ____ with rupture of pancreatic ___ resulting in a ____

Answer 27

acute pancreatitis vessels hemorrhage

Question 28

hemorrhagic pancreatitis on ultrasound appearance is varied , depending on the ___ of the hemorrhage ; ___ defined homogenous mass in the area of the pancreas may be seen , may appear ___ or ____

Answer 28

age well solid or cystic

Question 29

____ ____ is an irreversible progressive destruction of pancreas due to repeated episodes of acute pancreatitis

Answer 29

CHRONIC pancreatitis

Question 30

CHRONIC pancreatitis most common cause is ___ ___ associated with chronic ___ or ____ disease

Answer 30

alcohol abuse alcoholism biliary

Question 31

CHRONIC pancreatitis increases risk of patient developing ____ ____

Answer 31

pancreatic cancer

Question 32

with CHRONIC pancreatitis patients may also have ____ ( 20-40%) , a dilated ___ ___ ___ . or ___ of the splenic vein with extension into the ___ vein

Answer 32

pseudocyst common bile duct thrombosis portal

Question 33

some signs and symptoms of CHRONIC pancreatitis is - constant ____ and ___ pain - _____ loss -_____ - _____ mellitus

Answer 33

epigastric and back weight steatorrhea diabetes

Question 34

CHRONIC pancreatitis on ultrasound appears ____geneous, small echogenic ____ may be seen , ___ contours and ____ pancreatic duct

Answer 34

HETEROgeneous calcifications irregular dilated

Question 36

Endocrine neoplasms is also known as ____ cell tumors

Answer 36

Islet

Question 37

Exocrine neoplasms is also called ____ cell tumors

Answer 37

Acini

Question 38

The three types of islet cell tumors are - ____ (B cell ) - _____ - ______ ( G cell)

Answer 38

Insulinoma Glucagonoma Gastrinoma

Question 39

The most common islet cell tumor is _____ (60%) And the second most common is _____ (18%)

Answer 39

Insulinoma Gastrinoma

Question 40

Insulinoma (B cell ) is usually ____ and secretes ____.

Answer 40

Benign Insulin

Question 41

Glucagonoma is ___. High incidence of ___ .

Answer 41

Rare Malignancy

Question 42

Gastrinoma (G-cell) is the second most __\ functioning islet cell tumor and produces ___ -___ syndrome

Answer 42

Common Zollinger Ellison

Question 43

Gastrinoma is caused by non___ secreting pancreatic tumors , which secrete excessive amounts of ___

Answer 43

Insulin Gastrin

Question 44

With Glucagonoma patients are ____ caused by increasing level of the glucagon hormone

Answer 44

Hyperglycemic

Question 45

Insulinoma , Glucagonoma and Gastrinoma are usually found on the pancreas ___ and ____

Answer 45

Body Tail

Question 46

The types of acini cell tumors are - ______ - _______ - _____/_____

Answer 46

Adenocarcinoma Serous cystadenoma Mucinous cystadenoma / cystadenocarcinoma

Question 47

Adenocarcinomas are ___ tumors of pancreas ranked as ___ th leading cause of cancer related deaths in the US

Answer 47

Malignant 4

Question 48

____ accounts for 90% of all pancreatic malignancies. It can produce ___ gallbladder which is dilated CBD and GB

Answer 48

Adenocarcinoma Courvoisier

Question 49

With adenocarcinoma lab values show elevated - _______ - _______ -________ - _____ phosphate

Answer 49

Bilirubin Amylase Lipse Alkaline

Question 50

____ is a rare neoplasm it can be serous or mucinous

Answer 50

Cystadenoma

Question 51

With cystadenoma most are ____ but does have ____ potential this would be called _____

Answer 51

Benign Malignant Cystadenocarcinoma

Question 52

SEROUS cystadenoma is a ___ tumor . It’s more common in ___

Answer 52

Benign Women

Question 53

MUCINOUS cystadenoma or cystadenocarcinoma is a ___ tumor but can become ____ and is most common in ____

Answer 53

Benign Malignant Woman

Question 54

SEROUS cystadenoma is commonly found in the pancreas ____. MUCINOUS cystadenoma is commonly found on pancreas ___/____

Answer 54

Head Body/ tail

Question 55

____ _____ is an adenocarcinoma most common type

Answer 55

Pancreatic carcinoma

Question 56

Pancreatic carcinoma involves ____ portions of pancreas

Answer 56

Exocrine

Question 57

Pancreatic carcinoma accounts for more than 90% of all ____ pancreatic tumors

Answer 57

Malignant

Question 58

Pancreatic carcinoma affect ____ people more that ____

Answer 58

Black White

Question 59

Pancreatic carcinoma affects ____ more than ____

Answer 59

Males Females

Question 60

Patients are at risk for pancreatic carcinoma with a diet high in ___ . Increase with ___. Family ____ correlation ____ pancreatitis . And with ____

Answer 60

Fats Smoking History CHRONIC Age

Question 61

_____ ____ is the 4th most common cause of cancer related to breast and colon cancers

Answer 61

pancreatic carcinoma

Question 62

lab values that relate to pancreatic carcinoma are elevated ______, _____, ______ and ______ phosphatase

Answer 62

bilirubin amylase lipase alkaline

Question 63

the Courvoisier gallbladder sign is seen with ____ _____

Answer 63

pancreatic carcinoma

Question 64

pancreatic carcinoma is most common in the pancreatic _____, it appears as a ____ echoic mass and _____ defined. its usually greater than __cm.

Answer 64

head HYPOechoic poorly 2cm

Question 65

with pancreatic carcinoma on ultrasound you can see the dilated ___ ___ ( including intrahepatic ducts) through the ____. and division of ____ duct. Liver ____, ascites and regional _____

Answer 65

biliary tree CBD Pancreatic mets adenopathy

Question 66

pancreatic carcinoma appears ____echoic with ____ boarder mass located on the ____ of the pancreas. Dilated ____

Answer 66

HYPOechoic irregular head CBD

Question 67

_____ _____ is an inherited disorder of the exocrine glands causing viscous ( thick mucous) secretion and dysfunction of the pancreas exocrine function

Answer 67

Cystic fibrosis

Question 68

with cystic fibrosis the pancreas becomes ____ and ___ replacement occurs

Answer 68

fibrotic fatty

Question 69

cystic fibrosis can cause pancreatic duct ____

Answer 69

obstruction

Question 70

with cystic fibrosis there is pancreas ____ with increased ____ caused by fat replacement of the pancreatic tissue

Answer 70

atrophy echogenecity