Surgical diseases of the Pancreas

Question 1

the body and tail of the pancreas lie anterior to the

Answer 1

splenic artery and vein

Question 2

Chief excretory channel

Answer 2

Duct of Wirsung

Question 3

accessory duct

Answer 3

duct of santorini

Question 4

Blood supply to the pancreas comes from multiple

branches from the _____ and _____

Answer 4

celiac and superior mesenteric

arteries

Question 5

artery that supplies the body and tail of the pancreas

Answer 5

splenic artery

Question 6

arteries that supply the head of the pancreas

Answer 6

superior and inferior pancreaticoduodenal artery

Question 7

stimulates endocrine and exocrine secretion

Answer 7

parasympathetic

Question 8

inhibits secretion

Answer 8

sympathetic system

Question 9

responsible for exocrine secretion

Answer 9

acinar cells

Question 10

Responsible for endocrine secretion

Answer 10

Islet cells

Question 11

Hydrolyzes starch and glycogen to glucose, maltose,

maltotriose and dextrins

Answer 11

PANCREATIC AMYLASE

Question 12

missense mutation on the cationic trypsinogen, or

PRSS1, results

Answer 12

premature, intrapancreatic

activation of trypsinogen

Question 13

Activated to form chymotrypsin.

Answer 13

CHYMOTRYPSINOGEN

Question 14

Secreted by the pancreas as a proenzyme that

becomes activated by trypsin.

Answer 14

PHOSPHOLIPASE A2

Question 15

function of phospholipase A2`

Answer 15

Hydrolyzes phospholipids and, as with all lipases,

requires bile salts for its action

Question 16

Hydrolyze neutral lipid substrates like esters of

cholesterol, fat-soluble vitamins, and triglycerides

Answer 16

CARBOXYLIC ESTER HYDROLASE AND

CHOLESTEROL ESTERASE

Question 17

fxn of CARBOXYLIC ESTER HYDROLASE AND

CHOLESTEROL ESTERASE

Answer 17

Hydrolyze neutral lipid substrates like esters of

cholesterol, fat-soluble vitamins, and triglycerides

Question 18

secrete glucagon

Answer 18

alpha cells

Question 19

secrete insulin

Answer 19

β-cells

Question 20

secrete somatostatin

Answer 20

delta cells

Question 21

secrete ghrelin

Answer 21

epsilon cells

Question 22

secrete PP

Answer 22

PP cells

Question 23

function of insulin

Answer 23

Inhibits glycogenolysis, fatty acid breakdown, and

ketone formation, and stimulates protein synthesis

Question 24

major stimulant of somatostatin

Answer 24

intraluminal fat

Question 25

Release is stimulated by hypoglycemia, and by the | amino acids arginine and alanine

Answer 25

GLUCAGON

Question 26

glucagon release is stimulated by

Answer 26

hypoglycemia, and by the | amino acids arginine and alanine

Question 27

most important role of pancreatic polypeptide

Answer 27

glucose regulation through its | regulation of hepatic insulin receptor gene expression

Question 28

most potent enteral stimulator of PP release

Answer 28

protein

Question 29

function of amylin

Answer 29

modulation or counterregulation of insulin | secretion and function

Question 30

Inhibits insulin, and possibly somatostatin release, and augments glucagon release • Inhibits pancreatic exocrine secretion

Answer 30

PANCREASTATIN

Question 31

Stimulates growth hormone secretion via growth | hormone releasing hormone release from the pituitary

Answer 31

GHRELIN

Question 32

classification of Pancreatic true cysts

Answer 32

1. IPMN (intraductal papillary mucinous neoplasms) 2. SCN (Serous Cystadenoma) 3. MCN ( Mucinous Cystic Adenoma)

Question 33

most commonn type of precancerous cyst

Answer 33

IPMN

Question 34

3 clinical problems of pancreatic ductal adenocarcinoma

Answer 34

pain jaundice duodenal obstruction

Question 35

a collection of enzyme rich pancreatic juice that occurs early in the course of acute pancreatitis, or that forms after a pancreatic duct leak; located in or near the pancreas; it lacks a well organized wall of granulation or fibrous tissue

Answer 35

peripancreatic fluid collection

Question 36

A focal or diffuse area of nonviable pancreatic parenchyma, typically occupying > 30% of the gland and containing liquefied debris and fluid

Answer 36

Early pancreatic (sterile) necrosis

Question 37

an organized collection of sterile necrotic debris and fluid with a well defined margin or wall within the normal domain of the pancreas

Answer 37

late pancreatic (sterile) necrosis

Question 38

a collection of pancreatic juice enclosed within a perimitere of early granulation tissue, usually as a consequence of acute pancreatitis that has occured within the preceding 3-4 weeks

Answer 38

acute pseudocyst

Question 39

pancreatic fluid collection in which gross purulence (pus) is present, withh bacterial or fungal organisms documented to be present

Answer 39

pancreatic abcess

Question 40

a collection of pancreatic fluid surrounded by a wall of normal granulation and fibrous tissue, usually persisting for >6 weeks

Answer 40

chronic pseudocyst

Question 41

etiology of chronic pancreatitis

Answer 41

``` Toxic Metabolic Ideopathic Genetic Autoimmune Recurrent acute and severe Obstruction ```

Question 42

2 minimally invasive interventions for acute pancreatitis

Answer 42

video assissted retroperitoneal debridement | endoscopic transgastric neurosectomy

Question 43

surgical interventions for necrotizing pancreatitis

Answer 43

``` percutaneous drainage endoscopic neurosectomy combined percutaneous and endoscopic laparoscopic transabdominal debridement open debridement transgastric approach ```

Question 44

clinical feautre of mild acue pancreatitis according to classification of seveity

Answer 44

no organ failure | no local symptoms

Question 45

clinical feautre of moderate severe pancreatitis according to classificate of seveity

Answer 45

``` Transient organ failure (resolves in 48hrs) Local or systemic complications without persistent organ failure ```

Question 46

clinical feautre of severe acute pancreatitis according to classificate of seveity

Answer 46

Persistent organ failure involving 1 or more organs (>48hrs)