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37 Cards in this Set
- Front
- Back
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What converts trypsinogen --> trypsin
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enterokinase
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Pancrease Divisum
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Failure of fetal duct fusion of the ventral or dorsal pancreatic primordia.
The bulk of the secretions drain through the smaller caliber minor papilla. May predispose to chronic pancreatitis. |
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a ring of normal pancreatic tissue surrounds the 2nd part of the duodenum.
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Annular Pancreas; May present with duodenal obstruction.
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Viruses (such as mumps) may cause what in regards to the pancreas?
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Acute pancreatitis; primary cell injury (also caused by drugs, direct trauma and ischemia following shock)
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Name 3 mech of Acut pancreatitis
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Pancreatic duct obstruction; Primary Acinar Cell Injury; Defective Intracellular Transport of Proenzymes
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Accounts for 80% of cases of acute pancreatitis in western countries
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Alcoholism (Gallstones present in 35-60%)
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How do you dx acute pancreatitis?
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By the presence of elevated plasma amylase and lipase
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Key to managing acute pancreatitis?
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"rest" it. Restrict oral intake
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40-60% of pts with acute pancreatitis will develop an abscess; usually from what?
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gram negative orgs (like E.coli)
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By 24 hours, what will be > in AP?
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Serum amylase
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By the 3rd day, what will be > in AP?
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Serum lipase
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MCC of chronic pancreatitis (CP)?
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long-term alcohol abuse
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What gene mut is present in 25-20% of cases of CP?
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CFTR (but the effects of CF are not seen)
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Pancreatic fibrosis; acinar cell loss
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Chronic Pancreatitis
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CP spares what?
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the Islets
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What makes pseydocytes "pseudo"?
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NO epithelial lining
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Painless jaundice
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Pancreatic Carcinoma
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Benign neoplasms composed of glycogen-rich cuboidal cells, surrounding small (1-3mm) cysts containing clear, thin fluid.
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Serous cystadenoma
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What sex is Mucinous Cystic Neoplasm MC?
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Women (95%!)
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The cysts are larger than in serous cystadenoma, and the fluid is thick and “tenacious.” They are lined by mucin secreting columnar cells surrounded by dense stroma (ovarian like).
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Mucinous Cystic Neoplasms
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What is unique about Mucionus Cystic Neoplasms?
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They DO NOT connect to the pancreatic duct system
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What sex are Intraductal Papillary Mucionus Neoplasms (IPMNs) MC?
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men
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What part of the pancrease are IPMN MC?
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head
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What is the difference between IPMNs and Cystic Mucinous Lesions?
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They (IPMNs) lack the dense ovarian like stroma of the cystic mucinous lesions, and they involve larger pancreatic ducts
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Strongest environmental factor of Pancreatic Carcinoma
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Smoking (fatty diet, CP and DM also risk factors)
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MC mut of Pancreatic Carcinoma
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KRAS (. These point mutations impair the guanosine triphosphatase activity of the k-ras protein. Also leads to activation of several signal transduction pathways activating transcription factors Fos, and Jun.)
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MC Tumor Supressor Gene that is inactivated in Pancreatic Carcinoma
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CDKN2A (p16); SMAD4 and P53 also other TS genes that are inactivated
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Has been seen prior to development of Pancreatic Carcinoma, what do the epithelial cells show?
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Pancreatic Intraepithelial Neoplasias (PanINs); epithelial cells show telomere shortening
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Trousseu's sign
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Migrating thrombophlebitis of Pancreatic Carcinoma
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Courvoiser's sign
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Palpable gallbladder or pancreatic carincoma
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What tumor markers are often elevated in Pancreatic Carcinoma
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CA19-9, CEA
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60% of pancreatic carcinomas arise in what part of the pancreas?
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The head (20% are diffuse)
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Sequelae of pancreatic carcinoma in the head
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Obstructs the common bile duct; distends the biliary tree; jaundice
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Pancreatic Carcinomas of the body and tail remain silent for longer that PC of the head, why?
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PC of the body and tail DO NOT cause jaundice
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Beta Tumor
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Insulinoma (MC Endocrine Tumor)
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Alpha tumor
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Glucogonmoa (Endocine Tumor)
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G Cell Tumor
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Gastrinoma (Endocrine Tumor)
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