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25 Cards in this Set
- Front
- Back
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What cells serve an exocrine function in the pancreas?
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Acinar epithelial cells
Ductular cells |
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What is the main pancreatic duct called? Where does it drain from?
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Wirsung
Drains from ampulla of Vater Joins common bile duct |
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What is the accessory pancreatic duct called? Where does it drain from?
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Santorini
Most often drains into duodenum cranial to ampulla of vater |
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What is pancreas divisum? What are the complications associated with it?
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Most common congenital anomaly
Persistent separation of dorsal and ventral development anlages Secretions forced to drain via accessory duct of santorini Prone to pancreatitis via blockage of duct |
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What is an annular pancreas?
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Pancreas completely encircles the 2nd portion of the duodenum and may cause duodenal obstruction
Usually not a problem |
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What is the genetic inheritance of cystic fibrosis?
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Autosomal recessive
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What is the pathophysiology of acute pancreatitis?
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Activation of pancreatic proenzymes within the pancreas with autodigestion and inflammation
Caused by alcohol abuse and gallstones |
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How does alcohol abuse cause acute pancreatitis?
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Alcohol thickens ductal secretions, increases exocrine secretions and constricts sphincter of oddi
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What are the 3 proposed pathways in pathogenesis of acute pancreatitis?
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Duct obstruction
Acinar cell injury via drugs, trauma, ischemia, virus Defective intracellular transport |
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How do you test for acute pancreatitis?
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Test serum amylase and lipase levels - 2X normal
Serum immunoreactive trypsin |
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What is Turner's sign?
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Flank hemorrhage
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What is Cullen's sign?
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Periumbilical hemorrhage
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How does acute pancreatitis cause tetany?
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Consumption of free ionized calcium in the process of enzymatic fat necrosis
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What is an abdominal mass felt in acute pancreatitis?
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Pancreatic pseudocyst
Amylase in cyst and persistently elevated in serum |
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What are Ranson's criteria and how do they associate with acute pancreatitis prognosis?
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Test on admission and at 48 hrs
Admission: - WBC>16,000 - Age>55 - AST>250 - LDH>350 - glucose>200 48 hours: - Decrease Hct 10% - Increased BUN by >5mg/dL - Ca < 8 mg/dL - Base deficit > 4mEq/L - Fluid sequestration > 6L Number of signs present predicts mortality |
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How do you clinically manage acute pancreatitis?
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Supportive
Enteral feeding tube into jejunum IV feedings |
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How do you clinically manage pancreatic pseudocyst?
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Watchful management
Drainage; cystnterostomy; debridement; resection |
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Is the parenchymal damage by chronic pancreatitis reversible?
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No
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What are the consequences of chronic pancreatitis?
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Malabsorption
Type I DM (Brittle diabetes) Pancreatic pseudocysts Pleural effusion |
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How would you clinically manage chronic pancreatitis?
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Abstain from aclohol
Analgesics Inhibit pancreatic secretions Dilate surgical duct Porcine pancreatic enzymes |
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What are some cystic pancreatic neoplasms?
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Serous cystadenoma
Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm |
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What portion of the pancreas does pancreatic cancer typically involve?
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Head of the pancreas
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What genetic mutations are associated with pancreatic cancer?
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K-RAS, p16, p53, SMAD4, BRCA2
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What are risk factors in developing pancreatic cancer?
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Smoking
Chronic pancreatitis Partial gastrectomy Diet - meat Obesity |
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What is the whipple procedure?
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Pancreaticoduodenectomy
Removal of gastric antrum, gall bladder and distal common bile duct, head of pancreas, duodenum and proximal jejunum, and regional lymph nodes |
