Pancreas Sonography

Front 1

Visulization of pancreas may be limited by

Back 1

-overlying bowel gas
-patient body habitus

Front 2

pancreatic pathology is suspected when there is

Back 2

-severe epigastric pain
-abdominal pain that radiates to back and is lessened when patient leans forward, fetal position
-abdominal distention

Front 3

Pancreatitis-________ of the pancreas

Back 3

inflammation

Front 4

Pancreatitis is a ______ reaction to tissue destruction caused by _______enzymes rleased from damages of the ______pancreatic cells

Back 4

secondary, digestive, exocrine

Front 5

______activation of the pro-enzymes within pancreas result in______

Back 5

premature, autodigestion

Front 6

what are the 5bs?

Back 6

Blood, Booze, Bile, Bug, Birth

Front 7

What are the clinical presentation of acute pancreatitis?
___ ____ after a large meal
pain to the ____
fever and _____
bowel obstruction=___
acute _____ distress
gaseous distention of the_____

Back 7

severe pain,back,sweating, ileus, respiratory, abdomen

Front 8

What are the clinical symptoms of hemorrhagic pancreatitis?
pain to the ____
NV?
_____distention and il_us

Back 8

back, nausa and vomiting, abdomen, ileus

Front 9

What are the clinical presentations of chronic pancreatitis?
constant______and ____pain
ND
J___d___
______mellitus (m/b)
_______=fat feces
weight loss or weight gain?

Back 9

epigastric, back, nausea diarrhea, jaundice, diabetes, steatorrhea, weight loss

Front 10

What are the clinical presentations of adenocarcinoma?
weight gain or loss?
painless J___d___
____pain and ____ pain
NV
onset of______

Back 10

weight loss, jaundice, abdominal, back (50%), nausea, vomiting, diabetes

Front 11

Acute Pancreas sonographic appearance:
1)normal in ___ of patients
2)diffuse______ with loss of normal sonographic _____
3)Focal ________
4)___echoic or ____echoic than liver
5)loss of distention of ______vein
6)_____or ______ of pancreatic duct

Back 11

1)30%
2)enlargement, texture
3)enlargement
4)isoechoic, hypoechoic
5)splenac
6)dialation, compression

Front 12

Hemorrhagic Pancreatitis sonographic appearance:
1)focal areas of ___and parenchymal _____appearing as small ____
2)__ __ sign in flank area
3)acute-well defined ____mass
4)1wk-mass appears ___ with ___
5)several wks- norma or ___ and ____

Back 12

1)fat, necrosis, cysts
2)gray turners sign
3)homogenous
4)cystic, debris
5)normal, abcess, pseudocyst

Front 13

Phlegmonous pancreatitis sonographic appearance:
1)______with _____through transmission
2)usually involves ___sac, ____space, ____mesocolon

Back 13

1)hypoechoic, good
2)lesser, pararenal, transverse

Front 14

Abscess sonographic appearance:
1)depends on __and ___present
2)similar to ____ and ____
3)____walls with ____ internal echoes
4)____walls with ____internal echoes
5)ranges from echo ___to echo ____

Back 14

1)pus, debris
2)pseudocyst, pancreatitis
3)smooth, little/no
4)irregular, increased
4)free, dense

Front 15

Pseudocysts sonographic appearance:
1)size varies from __to __
2)wall may be s__,s__, well ___ or t____
3)___ or __level internal echoes with ^____enhancement
4)may have___appearance
5)may contain____producing debris
6)may migrate to ____ and _____

Back 15

1)2cm -20cm
2)sharp, smooth, defined, thickened
3)anechoic, low, posterior
5)shadowing
6)mediastinum, pelvis

Front 16

Chronic pancreatitis sonographic appearance:
1)_____with ^____ and ____
2)ductal ____ and _____ outline
3)focal or diffuse ____ of gland

Back 16

1)heterogenous, echogenicity, attenuation
2)dialation, irregular
3)enlargement

Front 17

Macrocystic adenoma sonographic appearance:
1)___walled
2)__locular/__locular cystic mass
3)___cystic spaces

Back 17

1)thick
2)uni, multi
3)large

Front 18

Microcystic sonographic appearance:
1)____mass
2)resembles _____
3)posterior _____
4)displacement, encasement, obstruction of
___, ___, ____
5)contains central ____

Back 18

1)anechoic
2)pseudocyst
3)enhancement
4)pseudocyst
5)calcifications

Front 19

Adenocarcinoma sonographic appearance:
1)focal __, difused ___enlargement of pancreas
2)involves____
3)___echoic mass
4)___ borders
5)____texture
6)enlarged GB called
7)biliary duct ____
8)A__t_s
9)____of liver
10)splenic vein. lymph nodes ____
11)

Back 19

1)90%, 10%
2)head
3)hypo
4)irregular
5)heterogenous
6)Courvoiser's sign
7)dialation
8)ascites
9)metastasis
10)enlargement

Front 20

Islet cell tumor sonographic appearance:
1)located @___/___
2)small well defined ___, ___,__ehoic mass
3)Large tumors are ____
4)____ and ___spaces seen in larger lesions

Back 20

1)tail/body
2)homogenous, solid, hypoechoic
3)echogenic
4)calcification, fluid

Front 21

Acute Pancreatitis lab values:
1) amylase^ for__hrs
2)lipase^ for __hrs
3)__wbc/bilirubin if obstruction

Back 21

1)48-72
2)5-14 days
3)^

Front 22

Hemorrhagic Pancreatitis Lab values:
1)__serum amylase and lipase
2)__hematocrit and serum calcium

Back 22

1)^
2)Decreased

Front 23

Chronic pancreatitis lab values:
___in feces

Back 23

fat

Front 24

complications of acute pancreatitis:

Back 24

Pseudocysts formation
phlegmon
abscess
homorrhage
biliary/duodenal obstruction
pancreatic ascites, acute peritonitis
thrombosis of splenic portal veins and smv
left pleural effusion

Front 25

complications of hemorrhagic pancreatitis

Back 25

-hemorrhagic necrosis of pancreatic parenchma
-hemorrhagic fluid into retroperitoneal tissue/peritoneal cavity
-hemorrhage into pancreatic pseudocyst

Front 26

complications of pseudocyst

Back 26

-rupture/drain to retroperitoneal cavity/GI tract
-ascites
-infection
-hemorrhage into pseudocyst (>4wk=surgery)

Front 27

complications of chronic pancreatitis

Back 27

-pseudocyst
-thrombosis of SV/PV
-dialation of biliary system
-carcinoma (if see focal mass)

Front 28

hemorrhagic pancreatitits etiology:
1)rapid progression of __ ___
2)occurs after ___meal
3)after ___ binge
3)h____and fat ____

Back 28

1)acute pancreatitis
2)large
3)alcohol
4)hemorrhage/necrosis

Front 29

Phlegmonous Pancreatitis etiology:
1)inflammed ___to ___ ___ that may precede to ___

Back 29

edema, soft tissues, necrosis

Front 30

Abscess etiology:
1)infected by __ ___
2)contains___
3)wall ___ w/time

Back 30

1)enteric bacteria
2)pus
3)thickens

Front 31

Pancreatic pseudocysts etiology:
1)what happens when active pancreatic enzymes are released into parenchyma?
2)where can it seep into?
3)fibrrous capsule or epithealial covering?
4)necrotic tissue>?
5)fat calcium looks ____underneath peritoneum

Back 31

1)lysis and necrosis of tissues occurs
2)encased in peritoneal fluid, forming a cyst
3)capsule
4)dysstrophic calcification
5)echogenic

Front 32

chronic pancreatitis etiology:
1)mainly caused by ____
2)20% is ____
3)main P duct may have ___
4)fibrous changes to ___, __, __,__

Back 32

1)alcohol
2)idiopathic
3)stones
4)pancreas, CBD, duodenum, plyorus

Front 33

Pancreatic Neoplasm Etiology:
1)95% are _____
2)derived from ____ducts of ___ part of pancreas
3)functionally___w/o secreting anything

Back 33

1)adenocarcinomas
2)pancreatic, exocrine
3)silent

Front 34

Islet cell tumor etiology:
1)___tumors are ___ and found at ___
2)most common functional tumors are:

Back 34

1)functional, malignant, head
2)insulinoma, gastrinoma

Front 35

What is the most important tumor of pancreas?
1)death is within___
2)___ is common risk factor
3)high__/___consumption also
4)___pancratitis

Back 35

adenocarcinoma=most common
1)12-14 mo
2)smoking
3)fat diet/alcohol
4)chronic

Front 36

cystadenoma/cystadencarcinoma are seen commonly in_____ and _____ of pancreas

Back 36

middle aged women, tail

Front 37

what is insulinoma?

Back 37

B cell tumor.
Size is 1 to 1.5cm
found body/tail

Front 38

What are symptoms of insulinoma?

Back 38

hypoglycemia/hyperinsulinemia, inslin shock, liver metastasis

Front 39

What is gastrinoma?

Back 39

G cell tumor
-produces Zollinger-Ellison Syndrome (peptic ulcers)