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31 Cards in this Set
- Front
- Back
MEN stands for what?
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multiple endocrine neoplasias
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the pancreas is how many organs?
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in reality, 2
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what % of pancreatic parenchyma is exocrine (w/ lobular units of acini)?
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85-90%
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what are the 4 parts/regions of the pancreas (all distinct & uniform lobulation)?
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head (including uncinate process), neck, body, & tail
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what is the most prominent part of the pancreas?
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the head
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the pancreas is what type of organ?
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retroperitoneal
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most adenoCAs of the pancreas arise where? how does it manifest clinically?
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at the junction of the bile duct
(jaundice clinically) |
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secretin is produced from the stomach in the presence of what?
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HCl
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secretin is carried by the blood, then stimulates the pancreas to produce what?
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pancreatic juices
(amylases, lipases) |
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the acinar cells are large, granular, and polarized, nuclei are where? whats apical, whats basal?
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apical: cytoplasm, eosinophilic, abundant zymogen granules
basal: nuclei, basophilic, abundant RER |
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in the exocrine pancreas, acinar cells drain into where?
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into the intercalated ducts
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what % of pancreas is endocrine component, and what are the 4 major cell types?
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1-2% islets of Langerhans
1.(60-70%) beta cells -insulin 2. alpha cells- glucagon 3. gamma- somatostatin 4. PP cells- pancreatic polypeptide |
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biopsy specimens are obtained form pancreas how?
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FNA & brushing cytology
(thru the duct of Wirsung) percutaneously, intraoperatively, or via ERCP endoscopic retrograde cholangiopancreatography |
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what is the Whipple procedure? when is it performed?
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most difficult, 6-8 hrs
for tumors of the pancreatic HEAD, common bile duct, ampullary or periampullary region...excise portions of all, and duodenum, distal stomach, and gall bladder |
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what is a distal pancreatectomy?
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basically a splenectomy w/ removal of the pancreas tail
so, pancreatic tail w/ attached spleen & portion of pancreatic body |
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pancreatic secretion of enzymes & zymogens depends on what?
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intestinal contents
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Regulate what pancreatic secretion:
secretin from duodenum--> CCK from duodenum--> neural stim.--> |
water & bicarb from duct cells
discharge of digestive enzs comes from vagal Ns |
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pancreatic fxn:
acid load from stomach, luminal FA--> FA & protein digestives--> enzs include--> trypsin--> |
stim. secretin production
trigger release of CCK trypsin, chymotrypsin, aminopeptidases, elastase, amylases, lipases, & phospholipases activates other enzs |
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give 5 ways the pancreas protects itself from autodigestion?
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1. enzs elaborated as inactive precursors, these are sequestered in memb-bound granules in acinar cells
2. protease inhibitors w/in acinar & ductal secretions 3. trypsin activates enz to degrade other zymogens 4. lysosomal hydrolases to degrade zymogen granules (as back up) 5. acinar cells resistant to trypsin, chymotrypsin, PlipaseA2 |
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what is Heterotropic pancreas?
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freq. congenital anomaly, MC in 2nd portion of duodenum (pancreatic rests), stomach & jejunum, Meckel's diverticulum, ileum, biliary tract, gallbladder, colon, spleen, omentum, ABD wall, etc.
(can see every pathologic change in heterotopia) |
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what is annular pancreas?
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rare, congenital anomaly
gross: pancreatic tissue encircling duodenum micro: PP cells ventral primordium of pancreas fails to rotate properly (can be assoc. w/ Down's) |
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what is pancreatitis (definition)?
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inflammation of the pancreas w/ acinar cell injury
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acute condition
ABD pain elevated pancreatic enzymes in blood & urine necrosis of pancreatic tissue |
acute pancreatitis!
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what is the spectrum of acute pancreatitis?
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mild, self-limited, interstitial/edematous pancreatitis-->severe, hemorrhagic, necrotizing pancreatitis w/ extensive fat necrosis
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in acute pancreatitis, fat necrosis can occur...often seen where?
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in females would be seen in breast, pt. would present w/ breast mass
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what is the gross appearance of acute pancreatitis?
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Gray-white proteolytic destruction of parenchyma
hemorrhage chalky-white fat necrosis, hard nodular micro has PMNs |
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what does the peritoneal fluid look like for acute pancreatitis?
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turbid, brownish, with fat globules floating in it
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80% of acute pancreatitis cases are assoc w/ what 2 things?
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1. 15% biliary tract dz, female 3:1 pancreatitis w/ stones 60%, 5% w/ stones-->get pancreatitis
2. 65% alcoholism, male 6:1 |
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in alcoholic, repetitive bouts of acute pancreatitis can lead to what?
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chronic pancreatitis
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DDX of acute ABD
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acute appendicitis
perforated peptic ulcer acute cholecystitis w/ rupture occlusion of mesenteric vessels w/ bowel infarction pancreatitis (post-prandial or after alcoholic binge, no prodrome) |
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the intense pain (referred to upper back) of acute pancreatitis may be assoc. w/ what?
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peripheral vascular collapse d/t release of bradykinin & PGEs (vasodilators), and endotoxemia w/ complement
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