Exocrine Pancreas Pathology Quiz

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Questions and Answers

What is the primary risk associated with an annular pancreas?

  • Duodenal obstruction (correct)
  • Pancreatic insufficiency
  • Development of pancreatic carcinoma
  • Increased fat necrosis

What condition arises due to the premature activation of trypsin in acute pancreatitis?

  • Liquefactive hemorrhagic necrosis (correct)
  • Dystrophic calcification
  • Peritoneal abscess
  • Pancreatic duct dilation

Which symptom is common in both acute and chronic pancreatitis?

  • Periumbilical hemorrhage
  • Back radiating abdominal pain (correct)
  • Elevated serum amylase
  • Steatorrhea

Which complication is specifically associated with acute pancreatitis due to E. coli infection?

<p>Pancreatic abscess (C)</p> Signup and view all the answers

What is a significant late complication of chronic pancreatitis?

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

Which substance is most likely consumed during fat necrosis in acute pancreatitis, leading to hypocalcemia?

<p>Saponification-related calcium (C)</p> Signup and view all the answers

Which imaging feature is indicative of chronic pancreatitis?

<p>Chain of lakes pattern (A)</p> Signup and view all the answers

Most cases of chronic pancreatitis in adults are primarily caused by which factor?

<p>Alcohol consumption (C)</p> Signup and view all the answers

Flashcards

Annular Pancreas

A congenital defect where the pancreas forms a ring around the duodenum, potentially leading to blockage of the duodenum.

Acute Pancreatitis

Inflammation and bleeding in the pancreas, usually caused by the pancreas digesting itself due to the activation of its own enzymes.

Gallstones and Acute Pancreatitis

A major cause of acute pancreatitis due to its impact on the gallbladder, leading to gallstones.

Pancreatic Pseudocyst

A complication of acute pancreatitis, where fibrous tissue encapsulates areas of liquefied pancreatic tissue and enzymes, creating a fluid-filled sac.

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Pancreatic Abscess

A serious complication of acute pancreatitis, often caused by E. coli, characterized by persistent abdominal pain, fever, and elevated amylase.

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Chronic Pancreatitis

Long-term scarring of the pancreas, usually resulting from repeated bouts of acute pancreatitis.

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Alcohol and Chronic Pancreatitis

A common cause of chronic pancreatitis in adults, often leading to pancreatic insufficiency and malabsorption.

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Secondary Diabetes Mellitus and Chronic Pancreatitis

A late complication of chronic pancreatitis caused by the destruction of insulin-producing cells in the pancreas, leading to difficulty regulating blood sugar.

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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 hemorrhage of the pancreas, often due to premature activation of pancreatic enzymes, particularly trypsin. Common causes include alcohol, gallstones, trauma, hypercalcemia, etc.

  • Acute Pancreatitis - Clinical Features:

    • Epigastric abdominal pain radiating to the back
    • Nausea and vomiting
    • Periumbilical/flank hemorrhage (necrosis spreading)
    • Elevated serum lipase (more specific than amylase)
    • Hypocalcemia due to fat necrosis

  • Acute Pancreatitis - Complications:

    • Shock due to hemorrhage and fluid shifts
    • Pancreatic pseudocysts (fibrous tissue surrounding liquefied necrosis and enzymes)
    • Pancreatic abscess (often due to E. coli)
    • Disseminated Intravascular Coagulation (DIC) and Acute Respiratory Distress Syndrome (ARDS)

  • Chronic Pancreatitis: Fibrosis of pancreatic parenchyma, often due to recurrent acute pancreatitis, but sometimes idiopathic. Common causes include alcohol abuse and cystic fibrosis.

  • Chronic Pancreatitis - Clinical Features:

    • Epigastric abdominal pain radiating to the back
    • Pancreatic insufficiency, leading to malabsorption and fat-soluble vitamin deficiencies (steatorrhea)
    • Amylase and lipase not useful for assessing chronic pancreatitis
    • Dystrophic calcification of the pancreas on imaging, showing a "chain of lakes" pattern associated with ductal dilation

  • Pancreatic Carcinoma: Adenocarcinoma arising from pancreatic ducts, typically affecting elderly individuals (average age 70).

  • Pancreatic Carcinoma - Risk Factors: Smoking and chronic pancreatitis.

  • Pancreatic Carcinoma - Clinical Features (Occur Late):

    • Epigastric abdominal pain and weight loss
    • Obstructive jaundice (pale stools, palpable gallbladder) typically associated with head of pancreas tumors
    • Secondary diabetes mellitus associated with body/tail tumors
    • Pancreatitis
    • Migratory thrombophlebitis (Trousseau sign) in about 10% of patients
    • Elevated CA 19-9 serum tumor marker

  • Pancreatic Carcinoma - Treatment: Surgical resection (Whipple procedure) for some cases.

  • Pancreatic Carcinoma - Prognosis: Very poor, with a 1-year survival rate below 10%.

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Exocrine Pancreas, Gallbladder, and Liver Pathology PDF

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