Podcast
Questions and Answers
Match the following risk factors with their association to pancreatic cancer:
Match the following risk factors with their association to pancreatic cancer:
Tobacco use = Thought to cause 20–25% of cases Obesity = Risk factor for pancreatic cancer Chronic pancreatitis = Associated with increased risk of pancreatic cancer Family history = Linked to increased risk of pancreatic cancer
Match the following manifestations with their association to carcinoma of the pancreas:
Match the following manifestations with their association to carcinoma of the pancreas:
Obstructive jaundice = May be painless Upper abdominal pain with radiation to back = Common late manifestation Enlarged gallbladder = May be painful Weight loss and thrombophlebitis = Usually late manifestations
Match the following demographic groups with their trend in pancreatic cancer incidence:
Match the following demographic groups with their trend in pancreatic cancer incidence:
Latina women = Rapidly rising incidence Non-Hispanic White women younger than age 55 years = Rapidly rising incidence Non-Hispanic Black women younger than age 55 years = Rapidly rising incidence Overall incidence in the United States = Expected to surpass colorectal cancer by 2040
Match the following anatomical locations with their percentage distribution of pancreatic carcinomas:
Match the following anatomical locations with their percentage distribution of pancreatic carcinomas:
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Match the following pancreatic cancer risk factors with their descriptions:
Match the following pancreatic cancer risk factors with their descriptions:
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Match the following pancreatic neoplasms with their descriptions:
Match the following pancreatic neoplasms with their descriptions:
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Match the following clinical findings of pancreatic cancer with their descriptions:
Match the following clinical findings of pancreatic cancer with their descriptions:
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Match the imaging technique with its primary usage in pancreatic cancer diagnosis and staging:
Match the imaging technique with its primary usage in pancreatic cancer diagnosis and staging:
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Match the laboratory finding with its potential indication in pancreatic cancer diagnosis:
Match the laboratory finding with its potential indication in pancreatic cancer diagnosis:
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Match the staging category with its description in pancreatic cancer diagnosis and staging:
Match the staging category with its description in pancreatic cancer diagnosis and staging:
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Match the TNM system term with its meaning in pancreatic cancer staging:
Match the TNM system term with its meaning in pancreatic cancer staging:
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Match the diagnostic procedure with its role in pancreatic cancer diagnosis:
Match the diagnostic procedure with its role in pancreatic cancer diagnosis:
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Match the clinical sign with its potential indication in pancreatic cancer diagnosis:
Match the clinical sign with its potential indication in pancreatic cancer diagnosis:
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Match the pancreatic cancer treatment with the corresponding statement:
Match the pancreatic cancer treatment with the corresponding statement:
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Match the pancreatic cancer treatment with the corresponding statement:
Match the pancreatic cancer treatment with the corresponding statement:
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Match the pancreatic cancer treatment with the corresponding statement:
Match the pancreatic cancer treatment with the corresponding statement:
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Match the following pancreatic cyst management strategies with their recommendations:
Match the following pancreatic cyst management strategies with their recommendations:
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Match the following pancreatic carcinoma facts with their descriptions:
Match the following pancreatic carcinoma facts with their descriptions:
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Match the following facts about tumors of the ampulla with their descriptions:
Match the following facts about tumors of the ampulla with their descriptions:
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What is the most common neoplasm of the pancreas?
What is the most common neoplasm of the pancreas?
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Which factor is NOT identified as a risk factor for pancreatic cancer?
Which factor is NOT identified as a risk factor for pancreatic cancer?
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What percentage of all cancers do pancreatic carcinomas account for?
What percentage of all cancers do pancreatic carcinomas account for?
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By 2040, pancreatic cancer is expected to surpass which cancer as the second leading cause of cancer-related deaths in the United States?
By 2040, pancreatic cancer is expected to surpass which cancer as the second leading cause of cancer-related deaths in the United States?
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Which imaging technique is more sensitive than CT for detecting pancreatic cancer and determining resectability?
Which imaging technique is more sensitive than CT for detecting pancreatic cancer and determining resectability?
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What is the commonly used staging system for pancreatic cancer?
What is the commonly used staging system for pancreatic cancer?
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What percentage of patients present with locally advanced disease?
What percentage of patients present with locally advanced disease?
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What may indicate obstruction by a neoplasm, but with exceptions?
What may indicate obstruction by a neoplasm, but with exceptions?
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Which imaging technique is generally the initial diagnostic procedure for detecting a mass in pancreatic cancer cases?
Which imaging technique is generally the initial diagnostic procedure for detecting a mass in pancreatic cancer cases?
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What are the laboratory findings that may be present in pancreatic cancer?
What are the laboratory findings that may be present in pancreatic cancer?
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What does the TNM system include for staging pancreatic cancer?
What does the TNM system include for staging pancreatic cancer?
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What is the primary usage of ERCP in pancreatic cancer diagnosis and staging?
What is the primary usage of ERCP in pancreatic cancer diagnosis and staging?
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What is the alternative to CT for pancreatic cancer diagnosis?
What is the alternative to CT for pancreatic cancer diagnosis?
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What is a sensitive technique for detecting pancreatic cancer and metastases?
What is a sensitive technique for detecting pancreatic cancer and metastases?
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What is used for pancreatic cancer diagnosis when cytologic diagnosis cannot be made?
What is used for pancreatic cancer diagnosis when cytologic diagnosis cannot be made?
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Why is ultrasonography unreliable for pancreatic cancer diagnosis?
Why is ultrasonography unreliable for pancreatic cancer diagnosis?
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What is more sensitive than CT for detecting pancreatic cancer?
What is more sensitive than CT for detecting pancreatic cancer?
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What is the recommended monitoring approach for pancreatic cysts?
What is the recommended monitoring approach for pancreatic cysts?
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What is the reported 5-year survival rate for tumors of the ampulla after resection?
What is the reported 5-year survival rate for tumors of the ampulla after resection?
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What is the prognosis for pancreatic carcinoma?
What is the prognosis for pancreatic carcinoma?
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What is the recommended approach for high-risk individuals with a family history of pancreatic cancer or genetic syndrome?
What is the recommended approach for high-risk individuals with a family history of pancreatic cancer or genetic syndrome?
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What is the impact of obesity on mortality in pancreatic cancer?
What is the impact of obesity on mortality in pancreatic cancer?
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When is surgical resection indicated for pancreatic neoplasms?
When is surgical resection indicated for pancreatic neoplasms?
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What is being studied for potentially premalignant pancreatic cysts?
What is being studied for potentially premalignant pancreatic cysts?
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What is the recommended referral for patients with carcinoma involving the pancreas and the ampulla of Vater?
What is the recommended referral for patients with carcinoma involving the pancreas and the ampulla of Vater?
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What is the role of metformin and statins in pancreatic cancer?
What is the role of metformin and statins in pancreatic cancer?
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What is the recommended management approach for patients whose disease progresses despite treatment?
What is the recommended management approach for patients whose disease progresses despite treatment?
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What should be considered for high-risk individuals with a family history of pancreatic cancer or genetic syndrome?
What should be considered for high-risk individuals with a family history of pancreatic cancer or genetic syndrome?
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When is EUS-guided ablative treatment feasible for ampullary adenomas?
When is EUS-guided ablative treatment feasible for ampullary adenomas?
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What percentage of pancreatic cancer patients have a family history of the disease in a first-degree relative?
What percentage of pancreatic cancer patients have a family history of the disease in a first-degree relative?
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What is the primary role of neuroendocrine tumors in pancreatic neoplasms?
What is the primary role of neuroendocrine tumors in pancreatic neoplasms?
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What is a common finding in the clinical presentation of pancreatic cancer?
What is a common finding in the clinical presentation of pancreatic cancer?
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Which genetic mutations are common in pancreatic cancer?
Which genetic mutations are common in pancreatic cancer?
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What percentage of pancreatic neoplasms do cystic neoplasms account for?
What percentage of pancreatic neoplasms do cystic neoplasms account for?
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What is a characteristic of serous cystadenomas?
What is a characteristic of serous cystadenomas?
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What is a potential indication of jaundice in pancreatic cancer diagnosis?
What is a potential indication of jaundice in pancreatic cancer diagnosis?
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What is the most common location for pain in pancreatic cancer cases?
What is the most common location for pain in pancreatic cancer cases?
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Which syndrome is NOT included in the hereditary syndromes associated with pancreatic cancer?
Which syndrome is NOT included in the hereditary syndromes associated with pancreatic cancer?
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What is a risk factor in the risk model for pancreatic cancer in people with new-onset diabetes?
What is a risk factor in the risk model for pancreatic cancer in people with new-onset diabetes?
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What is a common finding in the clinical presentation of pancreatic cancer?
What is a common finding in the clinical presentation of pancreatic cancer?
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What is the reported percentage of neuroendocrine tumors in pancreatic neoplasms?
What is the reported percentage of neuroendocrine tumors in pancreatic neoplasms?
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Study Notes
Pancreatic Carcinoma and Ampulla of Vater: Key Points
- Monitoring cysts by imaging tests (MRI) is recommended, with FNA if a cyst enlarges to 3 cm and other high-risk features develop.
- Surgical resection is indicated for mucinous cystic neoplasms, symptomatic serous cystadenomas, solid pseudopapillary tumors, and certain cystic tumors.
- EUS-guided ablative treatment for potentially premalignant pancreatic cysts is being studied.
- Pancreatic carcinoma has a poor prognosis, with 80-85% of patients presenting with advanced unresectable disease.
- Obesity may adversely affect mortality in pancreatic cancer, while metformin and statins may improve survival.
- Tumors of the ampulla have a better prognosis, with a reported 5-year survival rate of 20-40% after resection.
- Resection of cancer of the pancreatic head is feasible and results in reasonable survival in carefully selected patients.
- Annual screening with EUS and MRI should be considered for high-risk individuals with a family history of pancreatic cancer or genetic syndrome.
- All patients with carcinoma involving the pancreas and the ampulla of Vater should be referred to a specialist.
- Patients who require surgery and other interventions should be hospitalized.
- EUS-guided ablative treatment for ampullary adenomas may be feasible, but patients must be followed for recurrence.
- Meticulous efforts at palliative care are essential for patients whose disease progresses despite treatment.
Pancreatic Carcinoma and Ampulla of Vater: Key Points
- Monitoring cysts by imaging tests (MRI) is recommended, with FNA if a cyst enlarges to 3 cm and other high-risk features develop.
- Surgical resection is indicated for mucinous cystic neoplasms, symptomatic serous cystadenomas, solid pseudopapillary tumors, and certain cystic tumors.
- EUS-guided ablative treatment for potentially premalignant pancreatic cysts is being studied.
- Pancreatic carcinoma has a poor prognosis, with 80-85% of patients presenting with advanced unresectable disease.
- Obesity may adversely affect mortality in pancreatic cancer, while metformin and statins may improve survival.
- Tumors of the ampulla have a better prognosis, with a reported 5-year survival rate of 20-40% after resection.
- Resection of cancer of the pancreatic head is feasible and results in reasonable survival in carefully selected patients.
- Annual screening with EUS and MRI should be considered for high-risk individuals with a family history of pancreatic cancer or genetic syndrome.
- All patients with carcinoma involving the pancreas and the ampulla of Vater should be referred to a specialist.
- Patients who require surgery and other interventions should be hospitalized.
- EUS-guided ablative treatment for ampullary adenomas may be feasible, but patients must be followed for recurrence.
- Meticulous efforts at palliative care are essential for patients whose disease progresses despite treatment.
Understanding Pancreatic Cancer and Neoplasms
- Newonset diabetes mellitus after age 45 can be an early sign of pancreatic cancer, accompanied by weight loss.
- Factors in the risk model for pancreatic cancer in people with newonset diabetes include age, BMI, smoking, use of PPIs, diabetes medications, and levels of hemoglobin A1C, cholesterol, hemoglobin, creatinine, and alkaline phosphatase.
- 7% of pancreatic cancer patients have a family history of the disease in a firstdegree relative, compared to 0.6% of control patients.
- Genetic mutations, including KRAS oncogene mutations, inactivation of tumor suppressor genes, and DNA mismatch repair deficiency, are common in pancreatic cancer.
- Pancreatic cancers originate from pancreatic intraepithelial neoplasias, which are microscopic and measure less than 5 mm in diameter.
- 10–15% of pancreatic cancer cases occur as part of hereditary syndromes, including familial breast cancer, hereditary pancreatitis, and Lynch syndrome.
- Polymorphisms of genes for methylene tetrahydrofolate reductase and thymidylate synthase are associated with pancreatic cancer.
- Neuroendocrine tumors account for 1–2% of pancreatic neoplasms and can be functional or nonfunctional, producing various hormones.
- Cystic neoplasms account for less than 10% of pancreatic neoplasms and may be mistaken for pseudocysts.
- Clinical findings of pancreatic cancer include pain, vague and diffuse in the epigastrium, weight loss, hyperglycemia, and jaundice due to biliary obstruction by a cancer in the pancreatic head.
- Serous cystadenomas are benign, while mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, solid pseudopapillary tumors, and cystic islet cell tumors may be malignant.
- Pain is present in over 70% of pancreatic cancer cases, often vague, diffuse, and located in the epigastrium or left upper quadrant of the abdomen, and may radiate into the back.
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Description
Test your knowledge on pancreatic carcinoma and ampulla of Vater with this informative quiz. Explore key points on monitoring, treatment options, prognosis, and factors impacting survival. Ideal for medical professionals and individuals seeking to deepen their understanding of these conditions.