Notes in Chapter_33:_Pancreas

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Published	07/07/2024	Which hormone-secreting tumor is associated with dermatitis (necrolytic migratory erythema), diabetes, DVT, declining weight, and depression?{{c1::Glu…
Published	07/07/2024	A(n) {{c1::somatostatinoma}} is a tumor of pancreatic delta cells
Published	07/07/2024	Somatostatinoma may present with {{c1::diabetes}} due to inhibition of insulin
Published	07/07/2024	{{c1::Glucagonoma}} is a hormone-secreting pancreatic tumor associated with {{c2::necrolytic migratory erythema::derm}}
Published	07/07/2024	Somatostatinoma may present with {{c1::achlorhydria}} due to inhibition of gastrin
Published	07/07/2024	Which embryological pancreatic bud(s) contribute(s) to the main pancreatic duct?{{c1::Both ventral and dorsal buds :)}}
Published	07/07/2024	In suspected Zollinger-Ellison syndrome (gastrinoma), what is the next step for the following gastrin levels? - If gastrin level >1000 pg/mL n…
Published	07/07/2024	{{c2::Accessory pancreatic}} duct is also called the duct of {{c1::Santorini}} {{c2::Main pancreatic}} duct is also called the duct of {{c1:…
Published	07/07/2024	The {{c4::Kocher}} maneuver involves reflecting the duodenum and pancreatic head from the retroperitoneum which allows access to: - The infr…
Published	07/07/2024	The imaging test that determines if a patient with pancreatic cancer is a surgical candidate is a(n) {{c1::pancreatic protocol CT}}
Published	07/07/2024	The {{c1::stomach::organ}} is {{c2::opacified}} in a {{c3::pancreatic protocol CT scan::imaging}} with {{c4::water}}
Published	07/07/2024	What important anatomic relationships are identified during a pancreatic protocol CT scan?Relationship of the tumor to the: - {{c1::portal}} vein…
Published	07/07/2024	Resectable pancreatic tumors criteria:1) No distant mets2) No radiographic evidence of {{c4::superior mesenteric}} vein or {{c4::portal}} vein abutmen…
Published	07/07/2024	In pancreatic cancers, the imaging quality of {{c1::ERCP::imaging}} will be compromised by the presence of a(n) {{c2::stent}}
Published	07/07/2024	A(n) {{c3::biliary stent}} is indicated if {{c1::neoad}}juvant therapy is plannedor in cases where bilirubin exceeds {{c2::10}} mg…
Published	07/07/2024	Patients undergoing {{c2::portal}} vein resection will need to have a {{c1::duplex ultrasound::imaging test}} of the {{c1::neck::region…
Published	07/07/2024	For patients undergoing {{c2::portal}} vein resection, duplex ultrasound evaluates for patency of {{c1::internal jugular}} veins and {{c1::intern…
Published	07/07/2024	Serum tumor markers:{{c1::CA 19-9}} may be falsely {{c2::in}}creased in the setting of {{c3::obstructive jaundice}}
Published	07/07/2024	Serum tumor markers:{{c4::CA 19-9}} level > {{c3::1000}} in the absence of {{c1::jaundice}} is highly suggestive of {{c1::metastatic disease}}
Published	07/07/2024	Serum pancreatic tumor markers:A drop of {{c2::CA 19-9}} >{{c1::50}}% is associated with improved survival
Published	07/07/2024	Pancreatic cancer serum tumor markers:A low serum {{c1::CA 19-9}} or {{c1::Chromogranin A}} levels are not indicative of favorable tumor biology
Published	07/07/2024	The uncinate process of the pancreas rests on the {{c1::aorta::vessel}} behind the {{c1::SMV::vessel}}
Published	07/07/2024	Immediately behind the {{c2::neck}} of the pancreas forms the {{c1::portal vein::vessel}}
Published	07/07/2024	The {{c2::portal}} vein is formed by the {{c1::SMV}} and {{c1::splenic}} vessels
Published	07/07/2024	Head of the pancreas blood supply:{{c1::Superior}} and {{c1::inferior pancreaticoduodenal}} arteries
Published	07/07/2024	Body of pancreas blood supply:{{c1::Great}}, {{c1::inferior}}, and {{c1::dorsal pancreatic}} arteries
Published	07/07/2024	Tail of the pancreas blood supply:Splenic, {{c1::gastroepiploic}}, and {{c1::caudal pancreatic}} arteries
Published	07/07/2024	Pancreatic lymph node drainage is through the {{c1::celiac}} and {{c1::SMA}} nodes
Published	07/07/2024	In the pancreas, {{c1::ductal}} cells secrete {{c2::bicarb}} while {{c1::acinar}} cells secrete {{c2::digestive enzymes}}
Published	07/07/2024	The only pancreatic enzyme secreted in its active form is {{c1::amylase}}
Published	07/07/2024	Hormonal control of pancreas: - {{c1::Secretin}}: bicarb - {{c1::CCK}}: pancreatic enzymes - {{c1::Acetylcholine}}: pancreatic enzymes …
Published	07/07/2024	Hormonal control of pancreas:Somatostatin and {{c1::glucagon::hormone}} both decrease secretion of enzymes and bicarb secretion
Published	07/07/2024	Annular pancreas surgical treatment is {{c1::duodenojejunostomy}} or {{c2::duodenoduodenostomy}} with possible {{c3::sphincteroplasty}}
Published	07/07/2024	{{c3::Pancreas divisum}} occurs due to a failure of fusion between the pancreatic ducts and can cause pancreatitis most commonly from {{c2::…
Published	07/07/2024	Pancreas divisum ERCPA) {{c1::gall bladder }}B) common bile ductC) {{c2::duct of Santorini}}D) {{c2::duct of Wirsung}}E) renal hilum enhancement
Published	07/07/2024	Pancreas divisum is diagnosed with {{c1::ERCP::test}}, which will show {{c2::long::short/long}} duct of {{c3::Santorini}}
Published	07/07/2024	Pancreas divisum is treated surgically with ERCP with {{c1::sphincteroplasty}}
Published	07/07/2024	The most common location of heterotropic pancreas is in the {{c2::duodenum}}; treatment involves surgical resection if {{c1::symptomati…
Published	07/07/2024	The most common cause of death in acute pancreatitis is {{c1::sepsis}}
Published	07/07/2024	Acute pancreatitis without any risk factors (alcohol, gallstones, ERCP, hypercalcemia, high triglycerides)should trigger a workup for {{c1::malignancy…
Published	07/07/2024	The preferred imaging modality for necrotizing pancreatitis is CT w{{c1::ith}} contrast
Published	07/07/2024	Does necrotic pancreas show up as light or dark on CT scan?{{c1::Dark}}
Published	07/07/2024	Patients with gallstone pancreatitis should have a cholecystectomy after {{c1::they recover, on same hospital admission}}
Published	07/07/2024	{{c1::Fox's}} sign is ecchymosis in the {{c2::inguinal}} area
Published	07/07/2024	Pancreatic necrosis with negative blood cultures and aspirate is called sterile pancreatic necrosis and should be treated {{c1::conservatively wi…
Published	07/07/2024	What percent of acute pancreatitis patients get a necrotic pancreas?{{c1::15}}%
Published	07/07/2024	Infected pancreatic necrosis is treated with {{c1::surgical debridement}}
Published	07/07/2024	Pancreatic abscesses are treated with {{c1::surgical debridement}}
Published	07/07/2024	If there is {{c2::gas}} in necrotic pancreas, treat with {{c1::OPEN surgical debridement}}
Published	07/07/2024	The most common bacteria in necrotizing pancreatitis is {{c1::gram-negative rods (E. coli and pseudomonas)}}
Published	07/07/2024	The most important risk factor for necrotizing pancreatitis is {{c1::obesity}}
Published	07/07/2024	Pancreatitis can cause ARDS which is related to the release of {{c1::phospholipases}}
Published	07/07/2024	Pancreatitis can cause DIC, which is related to the release of {{c1::proteases}}
Published	07/07/2024	Other causes of elevated amylase/lipase (that AREN'T pancreatitis)? - {{c1::Cholecyst}}itis - {{c2::Perforated ulcer::H. pylori}} - {{c…
Published	07/07/2024	The most common risk factor for pancreatic pseudocyst is {{c1::chronic pancreatitis}}
Published	07/07/2024	The initial management for pancreatic pseudocyst is {{c1::observation for 3 months}}
Published	07/07/2024	A pancreatic pseudocyst that doesn't resolve after 3 months is treated with {{c1::cystogastrostomy}}
Published	07/07/2024	The management of a pancreatic pseudocyst NOT associated with chronic pancreatitis is {{c1::surgical resection}}
Published	07/07/2024	Pancreatic pseudocysts in a patient withOUT chronic pancreatitis have a high risk of {{c1::intraductal papillary-mucinous neoplasm}} or {{c2…
Published	07/07/2024	Which type of pancreatic pseudocyst has an extremely low risk of malignancy? - {{c1::Non-complex}} features - Purely {{c2::serous cystadenom…
Published	07/07/2024	The most common cause of pancreatic fistulas is {{c1::pancreatic surgery}}
Published	07/07/2024	Clinical course if pancreatic fistulas go untreated?{{c1::Most close spontaneously (esp if <200 mL/day)}}
Published	07/07/2024	Pancreatic fistulas are treated with drainage, {{c1::NPO}}, {{c1::TPN}}, and {{c2::octreotide::drug}}
Published	07/07/2024	Pancreatic fistulas surgical management includes {{c2::ERCP}} with {{c3::sphincterotomy}} and {{c1::pancreatic stent}} placement
Published	07/07/2024	After a pancreatic fistula closes post stent placement, the pancreatic stent is {{c1::removed}}
Published	07/07/2024	Pleural effusion in a pancreatitis patient is usually caused by a fistula between:{{c1::Nothing, there is no fistula (just retroperitoneal fluid migra…
Published	07/07/2024	Pleural effusion from pancreatitis is managed with {{c1::thoracentesis}} followed by conservative management ({{c2::NPO}} with {{c…
Published	07/07/2024	Most common causes of chronic pancreatitis?1st - alcohol2nd - {{c1::idiopathic}}
Published	07/07/2024	In chronic pancreatitis the e{{c1::x}}ocrine function is usually lost first
Published	07/07/2024	The treatment for malabsorption from pancreatic insufficiency is {{c1::pancrelipase}}
Published	07/07/2024	In chronic pancreatitis, CT scan the size of the pancreas shows {{c1::atrophy}}
Published	07/07/2024	Chronic pancreatitis ultrasound will show ducts > {{c1::4}} mm
Published	07/07/2024	The most sensitive test for chronic pancreatitis is {{c1::ERCP}}
Published	07/07/2024	{{c1::Lateral pancreaticojejunostomy}} (aka {{c2::Puestow}} procedure) is indicated in chronic pancreatitis when the duct size is > {{c3::8}} mm
Published	07/07/2024	If only distal pancreas is affected by chronic pancreatitis and the ducts are small the surgical management is {{c1::distal pancreatic resection}…
Published	07/07/2024	For isolated chronic pancreatitis of the head with small ducts, the surgical management is {{c1::Whipple}}
Published	07/07/2024	Duodenum preserving surgery for chronic pancreatitis isolated to the {{c2::head}} of the pancreas is the {{c1::Beger}} or {{c1::Frey}} procedure
Published	07/07/2024	Chronic pancreatitis pain control surgical interventions include {{c1::bi}}lateral thoracoscopic {{c1::splanchnic}}ectomy and{{c2::celiac ganglio…
Published	07/07/2024	In chronic pancreatitis patients who have a suspected stricture, it's imortant to first rule out {{c1::cancer}}
Published	07/07/2024	Common bile duct stricture in chronic pancreatitis surgical management includes {{c1::hepaticojejun}}ostomy or {{c1::choledochojejun}}ostomy
Published	07/07/2024	In pancreatic insufficiency, the pancreas must have <{{c1::10}}% function confirmed via {{c2::fecal fat}} testing
Published	07/07/2024	Pancreatic insufficiency diet should involved {{c1::high}} carb, {{c1::low}} fat, and {{c1::high}} protein(high or low)
Published	07/07/2024	The first test in an obstructive jaundice workup is {{c1::ultrasound}}
Published	07/07/2024	Obstructive jaundice workupUltrasound shows NO CBD stones and NO mass, the next test is {{c1::MRCP}}
Published	07/07/2024	Pancreatic {{c1::adenocarcinoma}} tumors have a {{c2::p16}} mutation 95% of the time ({{c3::cyclin}} tumor supressor gene)
Published	07/07/2024	Pancreatic adenocarcinoma initially spreads {{c1::lymphatically}}
Published	07/07/2024	70% of pancreatic adenocarcinomas are located in the {{c1::head}} of the pancreas
Published	07/07/2024	90% of pancreatic adenocarcinomas are {{c1::pancreatic ductal adenocarcinomas (PDAC)::subtype}}
Published	07/07/2024	The type of pancreatic adenocarcinoma with the {{c2::lea}}st favorable prognosis is {{c1::Pancreatic Ductal Adenocarcinoma (PDAC)}}
Published	07/07/2024	Pancreatic cancer is usually unresectable if it has invaded: - {{c1::Portal}} vein - {{c1::Superior Mesenteric}} vein - {{c2::Retroperi…
Published	07/07/2024	A pancreatic tumor is biopsied if it has {{c1::metastases}} or it is unresectable
Published	07/07/2024	Chronic pancreatitis can be differentiated from obstructing malignancy via imaging with {{c1::MRCP}}
Published	07/07/2024	Double duct sign shows dilation of the {{c1::common bile duct}} and the {{c1::pancreatic duct}}
Published	07/07/2024	Post-Whipple leak is managed with {{c1::drains}}
Published	07/07/2024	A post-Whipple complication is {{c2::delayed gastric emptying}}, which is treated with {{c1::metoclopramide}}
Published	07/07/2024	A post-Whipple complication is a(n) {{c2::marginal ulcer}}, which is treated with {{c1::PPIs}}
Published	07/07/2024	Bleeding after a Whipple procedure is managed with {{c1::angioembolization}}
Published	07/07/2024	The most common pancreatic neuroendocrine tumor is a(n) {{c1::non-functionaloma}}
Published	07/07/2024	The most common functional pancreatic neuroendocrine tumor is a(n) {{c1::insulinoma}}
Published	07/07/2024	Most (90%) non-functional pancreatic neuroendocrine tumors are {{c1::malignant::benign/malignant}}
Published	07/07/2024	Pancreatic neuroendocrine tumor symptoms are managed with {{c1::octreotide::drug}}
Published	07/07/2024	Most (90%) insulinomas are {{c1::benign::benign/malignant}}
Published	07/07/2024	The surgical management for insulinoma is {{c2::enucleation}} if < {{c1::2}} cm and {{c2::formal resection}} if > {{c1::2}} cm
Published	07/07/2024	The chemotherapy used for {{c2::insulin}}omas is 5-fluorouracil and {{c1::streptozocin}}, which works via direct toxicity to {{c2::beta (insulin)…
Published	07/07/2024	Other than octreotide, high dose {{c1::diazoxide}}, which has dose-limiting {{c2::edema}};can help with symptoms of hypoglycemia in insulino…
Published	07/07/2024	The most common MEN-1 tumor is {{c1::gastrinoma}}
Published	07/07/2024	Most gastrinomas are found in the gastrinoma triangle which is composed of:1) {{c1::Neck}} of the pancreas2) {{c2::Common bile duct}}3) {{c3::3rd port…
Published	07/07/2024	A gastrin level of greater than {{c1::1000}} is diagnostic for gastrinoma
Published	07/07/2024	The management of gastrinoma involves {{c2::enucleation}} if <{{c1::2}} cm or {{c2::formal resection}} if >{{c1::2}} cm
Published	07/07/2024	The single best imaging test for localizing gastrinoma is {{c1::octreotide scan}}
Published	07/07/2024	Gastrinoma located in the {{c2::duodenum}} is resected with primary closure; if there is extensive invasion a(n) {{c1::Whipple procedure}} is per…
Published	07/07/2024	The most common location of glucagonoma is the {{c1::tail of pancreas}}
Published	07/07/2024	Glucagonoma skin rash is treated with {{c2::zinc}}, {{c1::amino}} acids, and {{c1::fatty}} acids
Published	07/07/2024	The most common functional neuroendocrine tumors in tail of pancreas are {{c1::glucagonoma}} and {{c1::VIPoma}}
Published	07/07/2024	An endocrine tumor that can cause gallstones is a(n) {{c1::somatostatinoma}}
Published	07/07/2024	In pancreatic cancer which is worse: venous invovement or arterial involvement?{{c1::Arterial}}
Published	07/07/2024	All pancreatic cancer patients get {{c1::adj}}uvant chemo
Published	07/07/2024	{{c3::FOLFIRINOX::acronym}} drugs for {{c2::pancreatic}} cancer: - {{c1::Folic acid}} - {{c1::5FU}} - {{c1::Irinotecan}} - {{c1::O…
Published	07/07/2024	{{c2::Octreotide}} scan can detect {{c1::neuroendocrine}} cells
Published	07/07/2024	Pancreatic fistulas are much more likely to close if they have an output of < {{c1::200}} cc/day
Published	07/07/2024	{{c1::Grey Turner's}} sign is ecchymosis in the {{c2::flank}} area
Published	07/07/2024	{{c1::Cullen's}} sign is ecchymosis in the {{c2::umbilical}} area
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