Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
174 Cards in this Set
- Front
- Back
|
Cystic fibrosis is ____.
|
hereditary
|
|
|
Cystic fibrosis is a ____ ____ exorcrine disorder.
|
autosomal recessive
|
|
|
With cystic fibrosis the organs become clogged w/ ____ secreted by the ____ glands.
|
mucus, exocrine
|
|
|
What organs become clogged w/ cystic fibrosis?
|
pancreas, lungs, intestines
|
|
|
The ____ & ____ become dilated w/in the pancreas w/ cystic fibrosis.
|
ducts & acini
|
|
|
What is the incidence of cystic fibrosis?
|
1 in 2,000
|
|
|
What are the 4 clinical symptoms of cystic fibrosis?
|
abdominal pain, bloating & flatulence, failure to thrive, glucose intolerance/diabetes
|
|
|
W/ cystic fibrosis, visualization of the pancreas is hindered by ____ of the ____ ____.
|
distention of the GI tract
|
|
|
The pancreas usually appears ____ w/ cystic fibrosis.
|
hyperechoic
|
|
|
T or F. W/ cystic fibrosis, echo texture of the pancreas cannot be compared to the liver because the liver is often abnormal.
|
TRUE
|
|
|
What is the appearance of the liver in someone w/ cystic fibrosis?
|
fatty infiltration, PHT, stasis, sequella, cirrhosis, GB typically not visualized or filled w/ sludge
|
|
|
There are ____ ____ in the GI tract w/ cystic fibrosis.
|
chronic obstructions
|
|
|
The GI tract has ____ ____ ____ w/ cystic fibrosis.
|
thickened irregular folds
|
|
|
There is an appearance of ____ ____ in neonates w/ cystic fibrosis.
|
meconium ileus
|
|
|
The median survival rate is ____ yrs of age for pts w/ cystic fibrosis.
|
28
|
|
|
Inflammation of the pancreas in which pancreatic enzymes autodigest the pancreatic tissue is called:
|
pancreatitis
|
|
|
Pancreatitis may be ____ or ____.
|
acute or chronic
|
|
|
The most common causes of pancreatitis in the western countries are ____ & ____.
|
alcoholism & gallstones
|
|
|
Gallstones account for more than ____% of all pancreatitis cases.
|
85&
|
|
|
In children ____ is the most common cause of pancreatitis.
|
trauma
|
|
|
In adolescents & young adults ____ is a common cause of pancreatitis.
|
mumps
|
|
|
(causes of pancreatitis) I GET:
|
idiopathic, gallstones, ethanol, trauma
|
|
|
SMASHED:
|
steroids, mumps, autoimmune disease, snake bite, hypercalcemia, ERCP, drug exposure
|
|
|
Obstruction can lead to ____ _____ which may cause ducts to rupture.
|
pancreatic hypersecretion
|
|
|
Pancreatitis can also be caused by:
|
bile/duodenal reflux, cancer, infection, hereditary, metabolic disorders
|
|
|
Sudden focal or diffuse inflammation of the pancreas is known as ____ ____.
|
acute pancreatitis
|
|
|
Treatments for acute pancreatitis include ____ & ____ ____.
|
NPO & fluid rehydration
|
|
|
Acute pancreatitis is associated w/ severe ____, ____ & ____.
|
pain, nausea & vomitting
|
|
|
Pain w/ acute pancreatitis is relieved by ____ or ____.
|
sitting or bending
|
|
|
Three symptoms of acute pancreatitis include:
|
paralytic ileus, ARDS, & acute tubular necrosis
|
|
|
What is paralytic ileus?
|
contents of intestines are unable to pass so there is obstruction
|
|
|
What is ARDS?
|
acute adult respiratory distress syndrome
|
|
|
What lab values are increased w/ acute pancreatitis?
|
amylase, lipase (stays elevated), leukocytosis, ALP & bilirubin if biliary obstruction is present
|
|
|
The pancreas appears normal in approx ____% of cases.
|
30%
|
|
|
The pancreas appears ____ echogenic than the liver is is typically ____ w/ acute pancreatitis.
|
less, hypoechoic
|
|
|
There is a loss of ____ ____ w/ acute pancreatitis.
|
landmark visualization
|
|
|
W/ acute pancreatitis, ____ ____ may be noted.
|
peripancreatic fluid
|
|
|
What is the modality of choice to image acute pancreatitis?
|
CT
|
|
|
What may be performed to remove stones in the CD?
|
ERCP (endoscopic retrograde cholangiopancreatography)
|
|
|
What are some common complications w/ acute pancreatitis?
|
edema, pseudocyst, hemorrhage, abscess, obstruction, ascites, thrombis & LT pleural effusion
|
|
|
When does edematous form of pancreatitis occur?
|
when the pancreas goes thru inflammatory changes & interstitial edema
|
|
|
W/ edematous form of pancreatitis the pancreas is ____ & ____ echogenic.
|
enlarged, less
|
|
|
A spherical collection of pancreatic enzymes that arise from inflammatory processes, necrosis or hemorrhage is:
|
pseudocyst
|
|
|
A ____ is a complication of pancreatitis or trauma.
|
pseudocyst
|
|
|
There is a ____ ____ but no ____ ____ w/ a pseudocyst.
|
fibrous capsule, endothelial covering
|
|
|
What is the most common complication assoc w/ acute pancreatitis?
|
pseudocyst (10-20% of pts)
|
|
|
Pseudocysts acount for ____ of all cystic pancreatic lesions.
|
2/3
|
|
|
Pseudocysts are most often associated w/ ____ or ____ disease.
|
alcoholism, biliary
|
|
|
There is a persistant elevation of ____ w/ a pancreatic pseudocyst.
|
serum amylase
|
|
|
What is the typical size of a pseudocyst?
|
2 - 20 cm
|
|
|
When a fluid-debris level is seen w/in a pseudocyst than ____ or ____ should be considered.
|
hemorrhage or abscess
|
|
|
What could a pancreatic pseudocyst be mistaken for?
|
stomach, bowel, duodenal diverticulum, dilated duct, vein, tumor
|
|
|
What are some complications of a pancreatic pseudocyst?
|
rupture & drainage into the peritoneal cavity or GI tract, ascites, erosion/infection, portal splenic thrombis
|
|
|
Decompression intervention is required if a pseudocyst is > than ____ or persists longer than ____ wks.
|
5 cm, 6
|
|
|
A severe inflammatory form of acute pancreatitis that spreads outside the pancreas is called:
|
phlegmonous pancreatitis
|
|
|
Phlegmonous pancreatitis causes localized areas of diffuse ____ ____ of ____ ____.
|
inflammatory edema, soft tissue
|
|
|
Phlegmonous pancreatitis may lead to ____ & ____.
|
necrosis & suppuration
|
|
|
Extension outside of the gland occurs in ____% of patients w/ acute pancreatitis.
|
18 - 20%
|
|
|
What is the sono appearance of phlegmonous pancreatitis?
|
hypoechoic mass adjacent to the pancreas w/ good thru transmission
|
|
|
What does phlegmonous pancreatitis usually involve?
|
the lesser sac, left anterior pararenal space & transverse mesocolon
|
|
|
A type of acute pancreatitis seen in 2 - 5% of cases is ____ pancreatitis.
|
hemorrhagic
|
|
|
Hemorrhagic pancreatitis is a rapid progression caused by ____ of ____ tissue.
|
autodigestion, pancreatic
|
|
|
There are areas of ____ & ____ of the vessels w/ hemorrhagic pancreatitis.
|
necrosis, rupture
|
|
|
What makes up the etiology of hemorrhagic pancreatitis?
|
sudden escape of active lytic pancreatic enzymes into glandulaar tissue
|
|
|
What are the main symptoms of hemorrhagic pancreatitis?
|
severe abdominal pain, nausea, vomitting, distention, bruising
|
|
|
Cullen sign=
|
periumbilical pain
|
|
|
Grey-turner sign=
|
flank pain
|
|
|
Fox sign=
|
infrainguinal pain
|
|
|
There is a decreased ____ & ____ ____ w/ hemorrhagic pancreatitis.
|
hematocrit & serum calcium
|
|
|
What lab values are increased w/ hemorrhagic pancreatitis?
|
amylase & serum lipase
|
|
|
What are the main complications w/ hemorrhagic pancreatitis?
|
hemorrhagic necrosis of parenchyma, bleeding into retroperitoneal/peritoneal & pseudocyst
|
|
|
In the acute phase of hemorrhagic pancreatitis there is a well-defined ____ ____.
|
homogeneous mass
|
|
|
One week old hemorrhagic pancreatitis may have a ____ appearance w/ ____.
|
cystic/hetero, debris
|
|
|
Old hemorrhagic pancreatitis has the appearance of an ____ or ____ or could be ____.
|
abscess, pseudocyst, normal
|
|
|
About _____% of pts develop an abscess relative to severity of acute pancreatitis.
|
1 - 9%
|
|
|
What causes abscesses in the pancreas to develop?
|
infection of necrotic tissue or pseudocyst, hemorrhage, post-op
|
|
|
Abscesses usually occur ____ wks after a pancreatitis episode.
|
2 - 4 weeks
|
|
|
Pancreatic abscesses can be ____ or ____.
|
multilocular or unilocular
|
|
|
Where may a pancreatic abscess spread to?
|
mediastinum (superiorly), transverse colon (inferiorly), or pelvis
|
|
|
Abscesses are usually a ____ mass w/ ____ ____ walls.
|
complex, irregular thick
|
|
|
A pancreatic abscess has a similar appearance to a ____ & ____.
|
pseudocyst & pancreatitis
|
|
|
Two treatment options for pancreatic abscesses is:
|
percutaneous drainage & antibiotic therapy
|
|
|
An irreversible damage to the pancreas due to ongoing inflammation w/ progressive destruction is known as:
|
chronic pancreatitis
|
|
|
Chronic pancreatitis is caused by ____ ____.
|
relapsing pancreatitis (repeated acute pancreatitis)
|
|
|
What is the most common cause of chronic pancreatitis?
|
alcoholism
|
|
|
The predisposing factors of chronic pancreatitis include ____ & ____.
|
hypercalcemia & hyperlipidemia
|
|
|
At least ____% of chronic pancreatitis cases are caused by alcohol use.
|
60%
|
|
|
What is the most common cause of chronic pancreatitis in children?
|
cystic fibrosis
|
|
|
Chronic pancreatitis is more common in ____ & ____% of pts have no predisposing factors.
|
males, 40%
|
|
|
What lab values are associated w/ chronic pancreatitis?
|
steatorrhea (fat in stool) , abnormal glucose tolerance
|
|
|
Using ____ & ____ are not good indicators for chronic pancreatitis.
|
amylase & lipase
|
|
|
What are the common risk factors for having chronic pancreatitis?
|
alcohol abuse, obstruction of distal CBD & panc duct, renal failure
|
|
|
Chronic pancreatitis causes persistant ____ & ____ pain radiating to the ____ ____ area.
|
epigastric & back, left lumbar
|
|
|
What are the other common symptoms of chronic pancreatitis?
|
nausea, vomitting, flatulence, weight loss, diabetes
|
|
|
The pancreas is either ____ or ____ in size w/ chronic pancreaitits.
|
normal or small
|
|
|
The pancreas appears ____ w/ increased ____ with chronic pancreaititis.
|
heterogeneous, echogenicity
|
|
|
There is an irregular contour of the ____ ____ & ____ ____ with chronic pancreatitis.
|
pancreatic duct, ductal dilatation
|
|
|
There is increased ____ secondary to fibrotic, fatty changes in someone w/ chronic pancreatitis.
|
attenuation
|
|
|
What are 3 main complications w/ chronic pancreatitis?
|
pseudocyst, dilatation of the biliary tree, associated pancreatic carcinoma
|
|
|
Consider carcinoma when ____ ____ are seen.
|
focal masses
|
|
|
What is the most accurate imaging for chronic pancreatitis?
|
cholangiopancreatography
|
|
|
The main goals of treatmeant for chronic pancreatitis are to:
|
stop alcohol use, control pain, & improve malabsorption problems
|
|
|
Benign neoplasms of the pancreas may originate from ____ or ____ tissue.
|
exocrine or endocrine
|
|
|
With any type of pancreatic CA there is an increased ____ & ____ secondary to obstruction.
|
ALP, bilirubin
|
|
|
What are the 4 types of pancreatic neoplasms?
|
cystadenoma/cystadenocarcinoma, adenocarcinoma, islet cell tumors, metastasis
|
|
|
An adenoma characterized by multiple cystic masses containing secreted material is a _____.
|
cystadenoma
|
|
|
A malignant tumor derived from glandular tissue, in which secretions accumulate in the cysts is _____.
|
cystadenocarcinoma
|
|
|
What are the 2 classifications of a cystadenoma/cystadenocarcinoma?
|
microcystic & macrocystic
|
|
|
There is a ____ predominance w/ cystadenoma/cystadenocarcinoma
|
female
|
|
|
Microcystic adenoma is a type of ____ cystadenoma.
|
serous
|
|
|
A benign lobulated mass comprised of numerous small cysts is called ____ ____.
|
microcystic adenoma
|
|
|
There are typically less than ____ cysts within a microcystic adenoma measuring < ____.
|
6, 2 cm
|
|
|
Microcystic adenoma accounts for almost ____% of panc cystic neoplams.
|
50%
|
|
|
Microcystic adenoma is usually seen in pts that are over ____ yrs of age.
|
60
|
|
|
About 30% of microcystic adenoma occur in the ____.
|
tail
|
|
|
What is microcystic adenoma associated with?
|
von hippel-lindau syndrome
|
|
|
What are the symptoms of microcystic adenoma?
|
pain, weight loss, jaundice, & palpable mass
|
|
|
What is the sono appearance of a microcystic adenoma?
|
well circumscribed, hypo & hyperechoic areas, multiple cysts, solid echogenic mass
|
|
|
The ____ & ____ are highly vascular on doppler with a microcystic adenoma.
|
pseudocapsule & septa
|
|
|
A type of mucinous adenoma is a ____ ____.
|
macrocystic adenoma
|
|
|
A macrocystic adenoma is an ____ or ____ tumor.
|
malignant or benign
|
|
|
Macrocystic adenomas are ____ & believed to arise from ____.
|
slow-growing, ducts
|
|
|
Macrocystic adenomas may be ____ or ____ & has a better prognosis than ____.
|
unilocular or multilocular, adenocarcinoma
|
|
|
Where are macrocystic adenomas more commonly located?
|
in the body/tail (60%)
|
|
|
The mean age of occurance for macrocystic adenomas is ____.
|
25
|
|
|
What is the main symptom of a macrocystic adenoma?
|
vague upper abdominal discomfort
|
|
|
What is the sono appearance of a macrocystic adenoma?
|
large cysts w/ thick septations, well circumscribed, thin/thick walls, hypervascular, dilated ducts prox to tumor
|
|
|
An increased number of papillary projections & solid components are more likely to be ____.
|
malignant
|
|
|
Macrocystic adenomas may resemble ____ & may contain central ____.
|
pseudocysts, calcifications
|
|
|
Macrocystic adenomas may cause displacement, encasement or obstruction of what vessels?
|
CBD, panc duct & splenic vein
|
|
|
The treatment for a macrocystic adenoma is ____ due to high malignancy potential.
|
resection
|
|
|
What is the most common malignancy of the pancreas?
|
adenocarcinoma
|
|
|
Adenocarcinoma involves the ____ portion of the pancreas.
|
exocrine
|
|
|
What does adenocarinoma arise from?
|
ductal epithelium
|
|
|
T or F. Adenocarinoma is the 4th leading cause of CA death in the US.
|
TRUE
|
|
|
Adenocarcinoma represent approx ____% of pancreatic masses.
|
90%
|
|
|
Adenocarinoma is seen more in ____ ____.
|
elderly men
|
|
|
Where is adenocarinoma usually found?
|
in the pancreatic head (60-70%)
|
|
|
What are the 4 main risk factors of adenocarcinoma?
|
alcohol abuse, diabetes, hereditary pancreatitis, & smoking
|
|
|
T or F. Most of the time w/ adenocarcinoma, the symptoms occur late.
|
TRUE
|
|
|
There will already be localized spread by the time of diagnosis in ____% of pts w/ adenocarcinoma.
|
90%
|
|
|
T or F. Pancreatic head masses show symptoms earlier.
|
TRUE
|
|
|
What are the clinical symptoms of adenocarcinoma?
|
weight loss, jaundice, epigastic pain, weakness, diabetes, thrombophlebitis (lower ext's)
|
|
|
A particular lab finding with adenocarcinoma is ____.
|
steatorrhea
|
|
|
There is focal enlargement in ____% of adenocarcinoma cases.
|
90%
|
|
|
Adenocarinoma appears as a ____ defined ____ mass.
|
poorly, hypoechoic
|
|
|
What are the sono appearances of adenocarinoma?
|
homogenous/inhomogenous, enlarged panc, irregular borders, panc/biliary duct dilatation
|
|
|
What are the associated findings w/ adenocarcinoma?
|
enlarged GB w/ jaundice, PV involvement, SV enlargement, SMA displacement, compression of IVC, ascites/mets
|
|
|
When evaluating for adenocarinoma you should doppler the ____ & ____ veins for obstruction.
|
portal & splenic
|
|
|
What are 3 differential diagnosis of adenocarinoma?
|
focal pancreatitis, lymphadenopathy, ampullary carcinoma
|
|
|
What are islet cell tumors?
|
rare, functional or non-functional endocrine tumors arising from the islet of langerhan
|
|
|
Islet cell tumors may be either ____ or ____.
|
benign or malignant
|
|
|
Islet cell tumors are usually ____cm in size.
|
1 - 2 cm
|
|
|
What do islet cell tumors present as?
|
a small, well-circumscribed degenerative mass
|
|
|
Where are islet cell tumors usually located?
|
in the body & tail of the pancreas
|
|
|
Non functional islet cell tumors are most often ____ & found in the ____ of the panc.
|
malignant, head
|
|
|
What increases the likelihood of malignancy w/ islet cell tumors?
|
calcifications
|
|
|
What are the 2 most common functional islet cell tumors?
|
insulinoma & gastrinoma
|
|
|
The most common of the 2 functional islet cell tumors is the ____.
|
insulinoma (60%)
|
|
|
About 90-95% of insulinomas are ____.
|
benign
|
|
|
Insulinoma tumors are slightly more common in ____.
|
women (30-50 yrs)
|
|
|
Insulinoma tumors are associated w/ ____ & elevated ____ levels.
|
MEN (multiple endocrine neoplasia type 1), insulin
|
|
|
Insulinoma tumors typically appear as a ____ lesion.
|
solitary
|
|
|
The 2nd most common type of islet cell tumor is ____.
|
gastrinoma (18%)
|
|
|
More than 60% of gastrinomas become ____.
|
malignant
|
|
|
Gastrinoma are more common in ____ & is also associated w/ ____.
|
males, MEN
|
|
|
The symptoms of a gastrinoma is similar to ____ ____ disease.
|
peptic ulcer
|
|
|
Gastrinomas may be ____ or ____.
|
single or multiple (head or tail)
|
|
|
What are the symptoms of an active insulinoma?
|
hypoglycemia, headaches, confusion, sweating, palpitations, obesity, tremors
|
|
|
What are the symptoms of an active gastrinoma?
|
recurrent PUD, gastric hyperacidity, diarrhea, hypokalemia (low potassium)
|
|
|
What is the typical sono appearance of an islet cell tumor?
|
small, well-defined, homo, hypoechoic, hypervascular
|
|
|
The treatment for islet cell tumors is ____ ____.
|
surgical resection
|
|
|
What complications are associated w/ a pancreas transplant?
|
ischemia, rejection, AV complication, infection, pancreatitis
|
|
|
Why do we scan a transplanted pancreas?
|
to check arterial & venous anastomosis, fluid collections, and size & shape
|
