Pancreatic Cancer Overview
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What is the primary suspected cause of pancreatitis in 80% of the cases?

  • Gallstones (correct)
  • Scorpion sting
  • Trauma
  • Mumps

    • Which mechanism is involved in the pathogenesis of acute pancreatitis?

  • Delayed enzyme activation
  • Decreased enzyme production
  • Excessive insulin release
  • Autoactivation of pancreatic enzymes (correct)

    • What symptom is commonly associated with acute pancreatitis?

  • Sudden weight gain
  • Epigastric pain (correct)
  • Chest pain
  • Nausea with vomiting

    • Which of the following conditions is NOT typically associated with the development of pancreatitis?

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

    What is a potential consequence of the cytokine release during the acute phase of pancreatitis?

    <p>Local and systemic inflammatory response</p> Signup and view all the answers

    What is the definition of acute pancreatitis?

    <p>Acute inflammation of the pancreas over a short period of time</p> Signup and view all the answers

    What is the overall mortality rate associated with acute pancreatitis?

    <p>10%</p> Signup and view all the answers

    Which of the following options correctly identifies a risk factor for developing pancreatitis?

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

    What anatomical structure is associated with the pancreas?

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

    Which of the following is NOT a common symptom of acute pancreatitis?

    <p>Enhanced appetite</p> Signup and view all the answers

    What percentage of hospital admissions related to abdominal pain is attributed to pancreatitis?

    <p>3%</p> Signup and view all the answers

    Which statement accurately describes the impact of acute pancreatitis on the pancreas?

    <p>It causes an acute inflammatory response affecting pancreatic function.</p> Signup and view all the answers

    What role do inflammatory cytokines play in acute pancreatitis?

    <p>They promote inflammation and tissue damage.</p> Signup and view all the answers

    What is a common complication associated with pancreatic necrosis?

    <p>Chronic Kidney Injury</p> Signup and view all the answers

    What characterizes the initial phase of necrotising pancreatitis?

    <p>Severe SIRS due to cytokine release</p> Signup and view all the answers

    Which surgical management approach is indicated for infected pancreatic necrosis?

    <p>Percutaneous needle aspiration</p> Signup and view all the answers

    What is the risk associated with gallstones in relation to acute pancreatitis?

    <p>30% risk of second episode within an average of 3 months</p> Signup and view all the answers

    Which assessment criteria are used for evaluating the severity of necrotising pancreatitis?

    <p>Glasgow criteria and APACHE II</p> Signup and view all the answers

    What complication occurs due to pancreatic necrosis after 2 weeks?

    <p>Sepsis-related complications</p> Signup and view all the answers

    What type of necrosis accounts for the majority of acute pancreatitis-associated mortality?

    <p>Infected pancreatic necrosis</p> Signup and view all the answers

    What metabolic disturbance may occur as a complication of pancreatic necrosis?

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

    What is a primary cause of chronic pancreatitis?

    <p>Autoimmune diseases</p> Signup and view all the answers

    Which of the following is a common clinical feature of pancreatic cancer?

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

    What characterizes the tumor doubling time in pancreatic cancer?

    <p>60 days</p> Signup and view all the answers

    Which treatment option is often considered for patients with intractable pain due to chronic pancreatitis?

    <p>Endoscopic therapy</p> Signup and view all the answers

    Which of the following risk factors is associated with an increased likelihood of developing pancreatic cancer?

    <p>Chronic pancreatitis</p> Signup and view all the answers

    What is the mean survival time for patients with unresectable pancreatic cancer who have undergone bypass surgery?

    <p>6 months</p> Signup and view all the answers

    In chronic pancreatitis, what causes obstruction to acini?

    <p>Protein precipitates</p> Signup and view all the answers

    What is the primary indication for surgical intervention in chronic pancreatitis?

    <p>Intractable pain</p> Signup and view all the answers

    According to Courvoisier's law, a palpable painless gallbladder in a jaundiced patient is unlikely to be caused by which condition?

    <p>Gallstone disease</p> Signup and view all the answers

    What dietary modification is often recommended for patients with chronic pancreatitis?

    <p>Reduce fat intake</p> Signup and view all the answers

    Which sign is indicated by peri-umbilical bruising?

    <p>Cullen's sign</p> Signup and view all the answers

    Which of the following components is NOT part of the Glasgow (IMRIE) criteria?

    <p>Albumin greater than 10 mmol/L</p> Signup and view all the answers

    What is Charcot's triad characterized by?

    <p>Jaundice, Pyrexia, RUQ pain</p> Signup and view all the answers

    Which of the following imaging techniques is best performed after 3 days to judge severity in pancreatic conditions?

    <p>CT pancreas</p> Signup and view all the answers

    What critical laboratory value indicates severe disease based on the Glasgow criteria?

    <p>Albumin less than 10 mmol/L</p> Signup and view all the answers

    Which acute management strategy is NOT typically required for this condition?

    <p>Surgical intervention</p> Signup and view all the answers

    Which sign is indicative of flank bruising in hemorrhagic conditions?

    <p>Grey Turner's sign</p> Signup and view all the answers

    Which vital sign monitoring should occur hourly in cases with a Glasgow IMRIE score greater than 3?

    <p>All vital signs</p> Signup and view all the answers

    What condition can lead to systemic complications requiring management in patients with acute abdominal issues?

    <p>Alcohol withdrawal</p> Signup and view all the answers

    Which of the following is a common bedside investigation during the workup of nausea and vomiting?

    <p>Urine dipstick</p> Signup and view all the answers

    Which condition accounts for 80% of idiopathic cases related to pancreatitis?

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

    What is the role of cytokines during the pathogenesis of acute pancreatitis?

    <p>They trigger a local and systemic inflammatory response.</p> Signup and view all the answers

    Which statement accurately describes an early symptom of acute pancreatitis?

    <p>Pain that radiates to the back</p> Signup and view all the answers

    Which of the following mechanisms describes the autodigestive process in pancreatitis?

    <p>Activation of digestive enzymes leading to tissue destruction.</p> Signup and view all the answers

    What is a common risk factor for the development of acute pancreatitis aside from gallstones?

    <p>Drug use (e.g., Thiazides)</p> Signup and view all the answers

    Which of the following factors is commonly perceived as a risk factor for developing pancreatitis?

    <p>High-fat diet</p> Signup and view all the answers

    In acute pancreatitis, which physiological response to inflammation is primarily involved?

    <p>Release of inflammatory cytokines</p> Signup and view all the answers

    What percentage of overall hospital admissions for abdominal pain is accounted for by pancreatitis?

    <p>3%</p> Signup and view all the answers

    Which condition is least likely to be a direct cause of acute pancreatitis?

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

    What is the primary factor determining the severity stratification in acute pancreatitis?

    <p>Extent of pancreatic damage</p> Signup and view all the answers

    What is the typical overall mortality rate associated with acute pancreatitis?

    <p>10%</p> Signup and view all the answers

    Which anatomical structure is critically associated with the onset of acute pancreatitis due to obstruction?

    <p>Common bile duct</p> Signup and view all the answers

    What complication could arise from the release of pancreatic enzymes during acute pancreatitis?

    <p>Hemorrhagic pancreatitis</p> Signup and view all the answers

    What is a major contributing factor to mortality in acute pancreatitis?

    <p>Infected pancreatic necrosis</p> Signup and view all the answers

    Which surgical management approach is typically used for sterile necrosis?

    <p>Non-operative management</p> Signup and view all the answers

    What best describes the initial phase of necrotising pancreatitis?

    <p>Release of inflammatory cytokines</p> Signup and view all the answers

    What complication is most commonly associated with an episode of necrotising pancreatitis after 2 weeks?

    <p>Sepsis-related complications</p> Signup and view all the answers

    Which imaging technique is most useful for assessing pancreatic necrosis severity?

    <p>Dynamic CT</p> Signup and view all the answers

    What metabolic disturbance may occur as a consequence of pancreatic necrosis?

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

    What is the recommended timing for cholecystectomy after an acute gallstone pancreatitis episode?

    <p>6 weeks post-episode</p> Signup and view all the answers

    Which parameter is NOT part of the criteria used to assess the severity of necrotising pancreatitis?

    <p>Blood pressure readings</p> Signup and view all the answers

    What is the most common reason patients with chronic pancreatitis may undergo surgical intervention?

    <p>To address intractable pain</p> Signup and view all the answers

    Which of the following is a notable feature of the pathogenesis of chronic pancreatitis?

    <p>Formation of protein precipitates</p> Signup and view all the answers

    What is the prognosis for patients diagnosed with unresectable pancreatic cancer?

    <p>Mean survival of bypassed patients being 6 months</p> Signup and view all the answers

    Which condition is least likely to be associated with an increased risk for chronic pancreatitis?

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

    In patients with pancreatic cancer, which clinical feature is most commonly observed?

    <p>Progressive jaundice</p> Signup and view all the answers

    What role does calcium deposition play in chronic pancreatitis?

    <p>Contributes to obstruction of pancreatic acini</p> Signup and view all the answers

    Which management strategy is recommended for chronic pancreatitis patients experiencing significant pain?

    <p>Celiac nerve block procedure</p> Signup and view all the answers

    Which of the following accurately describes Courvoisier's law?

    <p>It implies that a palpable gallbladder in jaundiced patients is not due to gallstones</p> Signup and view all the answers

    Which of these factors is NOT a typical cause of chronic pancreatitis?

    <p>Obesity-related eating habits</p> Signup and view all the answers

    What is the typical tumor doubling time for pancreatic cancer?

    <p>60 days</p> Signup and view all the answers

    What combination of symptoms is indicative of Charcot's triad in cases of cholangitis?

    <p>Jaundice, pyrexia, RUQ pain</p> Signup and view all the answers

    Which Glasgow (IMRIE) criterion indicates an elevated calcium level associated with severe disease?

    <p>Calcium &gt; 16mmol/L</p> Signup and view all the answers

    What is the significance of a Glasgow IMRIE score greater than 3?

    <p>Predicts severe disease requiring ICU care</p> Signup and view all the answers

    Which diagnostic tool is recommended for judging severity and complications of pancreatitis after three days?

    <p>CT pancreas</p> Signup and view all the answers

    What should be introduced when possible during the management of acute pancreatitis?

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

    Which of the following represents a common laboratory investigation for assessing pancreatitis severity?

    <p>Serum amylase/lipase</p> Signup and view all the answers

    In cases of hemorrhagic pancreatitis, which sign would be indicative of flank bruising?

    <p>Grey Turner's sign</p> Signup and view all the answers

    What is commonly monitored along with vital signs in patients presenting with nausea and vomiting?

    <p>Urine output</p> Signup and view all the answers

    What should be avoided during the acute management of pancreatitis?

    <p>Surgical intervention</p> Signup and view all the answers

    Which imaging technique identifies gallstones during the workup of pancreatitis?

    <p>Ultrasound abdomen</p> Signup and view all the answers

    Study Notes

    Pancreatic Cancer

    • Pancreatic cancer doubling time: 60 days
    • 85% of pancreatic cancer cases are unresectable
    • Mean survival for bypassed patients: 6 months
    • 90% of patients who have pancreatic adenocarcinoma die within 12 months

    Courvoisier's Law

    • A palpable and painless gallbladder in a patient who has jaundice is likely not due to gallstones

    Risk Factors for Pancreatic Cancer

    • Age (80% of cases occur between 6th and 7th decade of life)
    • Smoking
    • Alcoholism
    • Diabetes
    • Chronic pancreatitis

    Clinical Features of Pancreatic Cancer

    • Progressive jaundice
    • Vomiting (due to duodenal obstruction)
    • Ascites
    • Back pain
    • Anorexia
    • Weight loss
    • Sister Mary Joseph nodule

    Management of Pancreatic Cancer

    • Palliative Treatment
      • Biliary stent
      • Gastro-jejunostomy
      • Coeliac axis block
    • Surgical Treatment
      • Whipple's procedure (resection of parts of the stomach, duodenum, pancreatic head and neck, gallbladder, and bile duct along with lymph node clearance)

    Pancreatic Cancer

    • 85% of pancreatic cancers are unresectable
    • Mean survival of bypassed patients is 6 months
    • 90% of patients die within 12 months from pancreatic adenocarcinoma
    • Tumour doubling time for pancreatic cancer is 60 days

    Courvoisier's Law

    • A palpable, painless gallbladder in a jaundiced patient is unlikely to be due to a gallstone

    Risk Factors for Pancreatic Cancer

    • 80% of cases occur in the 6th and 7th decades of life
    • The majority of cases are linked to:
      • Smoking
      • Alcoholism
      • Diabetes
      • Chronic pancreatitis

    Clinical Features

    • Progressive jaundice
    • Vomiting (duodenal obstruction)
    • Ascites
    • Back pain
    • Anorexia
    • Weight loss
    • Sister Mary Joseph nodule

    Management

    • Palliation
      • Biliary stent
      • Gastro-jejunostomy
      • Coeliac axis block
    • Surgery
      • Whipple's procedure (resection of part of stomach, duodenum, pancreatic head and neck, gallbladder and part of the bile duct, along with clearance of draining lymph nodes)

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    Description

    This quiz covers essential information about pancreatic cancer, including its doubling time, survival rates, risk factors, clinical features, and management options. Key points such as Courvoisier's Law and surgical treatments like the Whipple's procedure are also highlighted.

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