Exocrine Pancreas, Gallbladder, and Liver Pathology
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Questions and Answers

What is the primary cause of acute pancreatitis?

  • Gallstones (correct)
  • Hyperlipidemia
  • Cystic fibrosis
  • Alcohol consumption (correct)
  • Which clinical feature is most specific for pancreatic damage in acute pancreatitis?

  • Elevated lipase (correct)
  • Elevated amylase
  • Epigastric abdominal pain
  • Nausea and vomiting
  • What is a common complication associated with acute pancreatitis that presents as an abdominal mass?

  • Pancreatic pseudocyst (correct)
  • Pancreatic cancer
  • Pancreatic abscess
  • Chronic pancreatitis
  • Which option describes a major risk factor for chronic pancreatitis?

    <p>Cystic fibrosis</p> Signup and view all the answers

    In chronic pancreatitis, what imaging finding is characteristic of pancreatic duct changes?

    <p>Dystrophic calcification with a 'chain of lakes' pattern</p> Signup and view all the answers

    What is a late complication of chronic pancreatitis involving the destruction of islets?

    <p>Secondary diabetes mellitus</p> Signup and view all the answers

    What serious condition can arise from pancreatic pseudocyst rupture?

    <p>Hemorrhage and enzyme release into the abdominal cavity</p> Signup and view all the answers

    Which biochemical change is associated with fat necrosis in acute pancreatitis?

    <p>Hypocalcemia</p> Signup and view all the answers

    Study Notes

    Exocrine Pancreas, Gallbladder, and Liver Pathology

    • Annular Pancreas: A developmental malformation where the pancreas forms a ring around the duodenum, potentially causing obstruction.

    • Acute Pancreatitis: Inflammation and bleeding (hemorrhage) of the pancreas.

      • Triggered by premature activation of pancreatic enzymes, leading to the digestion of the pancreas.
      • Common causes include alcohol, gallstones, trauma, hypercalcemia, or hyperlipidemia.
      • Symptoms include epigastric pain radiating to the back, nausea, vomiting, periumbilical/flank bleeding, and elevated serum lipase (more specific for pancreatic damage) and amylase.
      • Potential complications include: shock, pancreatic pseudocysts (fibrous tissue surrounding liquefied necrosis with elevated amylase), pancreatic abscess (often due to E. coli, with high fever, and elevated amylase), disseminated intravascular coagulation (DIC), and Acute Respiratory Distress Syndrome (ARDS).
    • Chronic Pancreatitis: A fibrotic condition of the pancreas, often secondary to recurring acute pancreatitis.

      • Common causes include alcohol abuse (adults) and cystic fibrosis (children), but idiopathic cases exist.
      • Key symptoms include epigastric pain radiating to the back and pancreatic insufficiency (malabsorption causing steatorrhea and deficiencies in fat-soluble vitamins).
      • Amylase and lipase are not good markers for chronic pancreatitis.
      • Imaging may show dystrophic calcification and dilatation of pancreatic ducts.
    • Pancreatic Carcinoma: Adenocarcinoma arising from the pancreatic ducts.

      • Most common in the elderly (average age is 70 years).
      • Major risk factors include smoking and chronic pancreatitis.
      • Clinical signs often appear late in the disease, including epigastric pain, weight loss, obstructive jaundice (pale stools, palpable gallbladder), secondary diabetes (body/tail tumors), and pancreatitis.
      • Other features include migratory thrombophlebitis (Trousseau sign), and elevated CA 19-9 serum tumor marker
      • Surgical treatment may involve a Whipple procedure (removal of head/neck of pancreas, proximal duodenum, and gallbladder).
      • Prognosis is poor, with <10% 1-year survival.

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    Description

    This quiz covers important aspects of exocrine pancreas, gallbladder, and liver pathology, including conditions like annular pancreas and acute pancreatitis. Learn about the causes, symptoms, complications, and the underlying mechanisms of these conditions. Test your knowledge on both developmental malformations and inflammatory diseases affecting the gastrointestinal system.

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