URR 28 Flashcards
(100 cards)
1
Q
Diabetes mellitus
A
hyperglycemia
2
Q
Hyperglycemia is caused by:
A
diminished rate of insulin secretion
3
Q
Two type of diabetes mellitus
A
juvenile
adult
4
Q
Hyperglycemia is diagnosed by ___, ____, and ____
A
blood
urine
glucose tolerance
5
Q
insulin given in shots to allow normal metabolism
A
insulin dependent
6
Q
low carbohydrate diet controls condition
A
non-insulin dependent
7
Q
_____ causes cells to become dehydrated, cannot absorb glucose, acidosis occurs
A
severe diabetes
8
Q
digestive enzyme that breaks down carbs
A
amylase
9
Q
Amylase is secreted by the ____ and ____
A
pancreas
salivary gland
10
Q
Amylase is excreted by the ____
A
kidneys
11
Q
Amylase levels are tested in ____ or ___
A
urine
blood
12
Q
Urine levels remain increased for up to __ days after serum levels return to normal
A
7
13
Q
Increased amylase is associated with:
A
acute pancreatitis
ductal obstruction
oral contraceptive use
14
Q
Reduced levels of amylase are associated with
A
permanent damage of the pancreas
hepatitis
cirrhosis
15
Q
digests fats
A
lipase
16
Q
Increased lipase is associated with:
A
acute pancreatitis
ductal obstruction
17
Q
Increased trypsin in associated with:
A
acute pancreatitis
ductal obstruction
18
Q
Increased WBC is associated with:
A
infection
19
Q
Increased bilirubin is associated with:
A
biliary ductal obstruction at pancreas head
20
Q
Increased in blood glucose is associated with:
A
decreased pancreas function (diabetes)
21
Q
excess fecal fat
A
steatorrhea
22
Q
Steatorrhea is a sign of:
A
pancreatitis
23
Q
scope used to image the pancreas and duodenal ductal connections from within the GI tract
A
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
24
Q
A __ - ___ MHz probe is utilized to scan the adult pancreas
A
2.5
6.5
25
A __-__ MHz probe is utilized to scan pediatric pancreas
4
8
26
NPO for pancreas
8-12 hours
27
____ may be administered to reduce bowel gas
Simethicone
28
How to demonstrate the long axis of the pancreas
use the subcostal approach with probe in transverse oblique position with the notch side of the probe angled slightly more inferior than the non-notch side of the probe
29
_____ position will best demonstrate the pancreatic head/uncinate process
left lateral decubitus
30
Key technique used to visualize pancreas body
compression techniques to displace bowel gas
31
The ____ of the pancreas can be seen by placing the patient in the RLD position and using a coronal view with the spleen as an acoustic window
tail
32
______ administration can be used to better visualize the tail of the pancreas
oral contrast
33
Too much water in the stomach can cause:
posterior displacement of pancreatic tail
34
The aorta is ____ to the body of the pancreas
posterior
35
The celiac axis is ____ to the head of the pancreas
superior
36
Travels posterior and superior to the body and tail of the pancreas
splenic artery
37
artery seen entering the anterior portion of the head of the pancreas
gastroduodenal artery
38
The IVC is ____ to the pancreatic head/neck.
posterior
39
The left renal vein is _____ to the body and tail of the pancreas
inferior
40
The splenic vein is ____ and ____ to the body and tail of the pancreas
inferior
posterior
41
best landmark to locate the tail of the pancreas
splenic vein
42
joins the splenic vein posterior to the pancreatic head/neck, uncinate process posterior to the confluence
superior mesenteric vein
43
_____ of the uncinate process is a normal variant because this tissue has less fat than the rest of the gland
decreased echogenicity
44
In children the pancreas is mildly ___ to ____ compared to the liver
hypoechoic
isoechoic
45
Pancreatic echogenicity increases with ___
age
46
In the normal adult, the pancreas parenchyma is ____ to ___ to the liver tissue
isoechoic
hyperechoic
47
What characteristic of the pancreas makes it differ from other abdominal organs?
a. lack of dedicated arterial supply
b. lack of dedicated venous drainage
c. lack of encapsulation
d. presence of a ductal system
c
48
The uncinate process is anterior to the ____ and posterior to the ____.
a. IVC, SMV
b. SMV, splenic vein
c. IMV, main portal vein
d. right portal vein, left portal vein
a
49
The ____ courses anterior to the pancreatic head, while the ___ courses posterior to the pancreatic head.
a. CBD, gastroduodenal artery
b. Hepatic artery, splenic artery
c. SMV, IMV
d. gastroduodenal artery, CBD
d
50
What controls flow of pancreatic enzymes into duodenum through the Ampulla of Vater?
a. Sphincter of Wirsung
b. Sphincter of Oddi
c. Sphinter of Santorini
d. Pyloric sphincter
b
51
The majority of arterial blood is supplied to the pancreas by branches from:
a. celiac axis and SMA
b. SMA and IMA
c. right and left gastric arteries
d. right and left renal arteries
a
52
The SMA courses posterior to the ____ of the pancreas and to the left of the ____
a. body, tail
b. neck, IVC
c. body, SMV
d. tail, IVC
c
53
What 2 vessels merge posterior to the neck of the pancreas to form the main portal vein?
a. SMV, splenic vein
b. SMV, IMV
c. Splenic vein, IMV
d. right and left portal veins
a
54
If blood sugar levels surpass a minimum levels of __ mg/100dL, ____ release insulin to lower it.
a. 20, acinar cells
b. 50, Delta cells
c. 100, islets of Langerhans
d. 400, whipple cells
c
55
The pancreas produces all of the following, except:
a. secretin
b. amylase
c. sodium bicarbonate
d. trypsin
a
56
Which 2 GI tract hormones cause the production and release of pancreatic enzymes?
a. Trypsin and lipase
b. amylase and sodium bicarbonate
c. cholecystokinin and secretin
d. sodium bicarbonate and secretin
c
57
Which of the following cell types make up the Islets of Langerhans?
a. alpha
b. beta
c. delta
d. all the above
d
58
Hyperglycemia is a sign on _____, while hyperinsulinism is a sign of ____.
a. diabetes, insulinoma formation
b. insulinoma formation, gastrinoma formation
c. pancreatitis, diabetes
d. insulinoma formation, diabetes
a
59
Aside from the pancreas, what other gland secretes amylase?
a. kidneys
b. adrenals
c. duodenum
d. salivary gland
d
60
When evaluating serum and urine levels of a hormone in the body, which one provides normal levels first after treatment?
serum (blood)
61
Which of the following improves the visualization of the pancreas on ultrasound?
a. simethicone administration
b. large footprint transducer
c. graded compression
d. all the above
d
62
When evaluating the echogenicity of the pancreas, you must know:
a. the patient's gender
b. the patient's age
c. the patient's race
d. the patient's blood sugar level
b
63
most common congenital pancreatic anomaly
pancreas divisum
64
two embryonic pancreatic buds do not fuse properly
pancreas divisum
65
Separate portions of the pancreas with separate ductal systems
pancreas divisum
66
Pancreas divisum can lead to _____ due to abnormal ductal system and drainage of enzymes
pancreatitis
67
___% of patients have pancreas divisum
10
68
1-2 cm masses of ectopic pancreatic tissue
aberrant tissue
69
Aberrant tissue can be located in the ____, ____, and ____
duodenum
stomach
small bowel
70
Aberrant tissue is composed of ___ and ____ cells.
acinar
ductal
71
Head surrounds 2nd portion of duodenum
annular pancreas
72
complete or partial obstruction of duodenum due to pancreas; rare; surgery necessary
annular pancreas
73
Cystic fibrosis is an _____ disorder
autosomal recessive
74
causes pancreas to secrete a thick mucous
cystic fibrosis
75
Cystic fibrosis inhibits ___ function, which leads to decreased ____ levels
exocrine
lipase
76
Cystic fibrosis causes the pancreas to shrink with ____ and ____
fibrosis
fatty replacement
77
Duct obstruction in the pancreas may cause _____
cyst formation
78
Cystic fibrosis makes the pancreas more or less echogenic?
more
79
Most common complication of cystic fibrosis
meconium ileus
80
Polycystic disease is an _____ disorder
autosomal dominant
81
multiple cysts seen throughout pancreas; various sizes; seen with liver, kidney, and spleen involvement
polycystic disease
82
Ductal stones can be associated with ____
biliary obstruction
83
Echogenic foci with posterior shadowing
ductal stones
84
Pancreatic duct stone = no biliary tree dilatation unless:
stone blocks Ampulla of Vater
85
Normal pancreatic duct measures __mm or less
2
86
acute onset of inflammation of the pancreas
acute pancreatitis
87
Enzymes leak into surrounding tissues of pancreas; gland becomes edematous
acute pancreatitis
88
Symptoms of acute pancreatitis
sudden onset or abdomen and/or back pain
nausea
vomiting
weight loss
fever
89
Acute pancreatitis is typically triggered by ____ or ____
meal
excessive alcohol consumption
90
Some patients are able to relieve epigastric/back pain associated with acute pancreatitis by:
sitting
91
#1 cause of acute pancreatitis
biliary tract disease
92
#2 causes of acute pancreatitis
alcohol abuse
93
causes of acute pancreatitis
biliary tract disease
alcohol abuse
trauma
drugs
94
excess fecal fat
steatorrhea
95
Steatorrhea is a sign of ____, ____, or ___
inflammatory bowel disease
celiac disease
pancreatitis
96
Lipase will increase within ____ of onset of pancreatitis
48 hours
97
Amylase will increase within __-__ of onset of pancreatitis
3-6 hours
98
Complications of acute pancreatitis
1. pseudocyst
2. phlegmon
3. abscess
4. hemorrhage
5. thrombosis
6. pseudoaneurysm/aneurysm
7. ascites
8. dilated biliary system
9. inflammation
99
accumulation of pancreatic juices that is walled off and appears to be a cyst
pseudocyst
100
peripancreatic inflammation extends into surrounding tissues; can cause an inflammatory mass
phlegmon
