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Flashcards in The Surgical Review- Pancreas Deck (21)
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1

what gene is associated with tropical pancreatitis? and what is it associated with ingesting?

secretory trypsinogen inhibitor or SPINK1 gene, ingesting cassava root

2

new onset diabetes in association with a skin rash and a pancreatic mass in the tail is suggestive of what?

glucagonoma

3

what is rash called in glucagonoma?

necrolytic migratory erythema- seen mostly in the lower abdomen or perineum

4

steatorrhea and gallstones + pancreatic head tumor

somatostatinoma: inhibits pancreatic and biliary secretions

5

what is another name for VIPoma?

WDHA: watery diarrhea, hypokalemia, and achlorhydria
aka Verner-Morrison syndrome

6

medical treatment of VIPoma?

octreotide: a somatostatin analogue

7

how do you confirm diagnosis of insulinoma?

low fasting blood sugar and an elevated C peptide level

8

treatment of insulinoma?

enucleation

9

octreotide scanning is most useful for localization of which tumor?

gastrinoma

10

what is passer triangle?

the area where 90% of gastrinomas reside, junction of cystic duct and CBD, 2nd and 3rd portion of duo, and the neck and body of the pancreas

11

Ranson Criteria: 5

1. Age >55yrs
2. WBC >16,000
3. BG >200
4. Serum LDH >350
5. AST >250

12

preoperative ERCP in pts w gallstone pancreatitis needing lap chole is reserved for which two patient populations?

1. Concomitant cholangitis
2. Clearly biliary obstruction (TBili >4, jaundice)

13

pathophys of hereditary pancreatitis?

defect in trypsin inactivation, missense mutation of the trypsinogen gene (PRSS1)

14

the preferred definitive treatment for recurrent acute pancreatitis due to pancreas divisum is

minor papilla sphincterotomy

15

most common anatomic site of adenocarcinoma of the pancreas?

main pancreatic duct

16

what are 4 effects alcohol has on the pancreas?

1. A metabolic toxin to the pancreatic acinar cells
2. increases pancreatic duct permeability
3. transiently decreases pancreatic blood flow
4. inappropriately activated trypsin

17

what is the mean amount of alcohol consumed in patients in whom pancreatitis develops?

100-175g/day

18

what is type 3 pancreatitis?

diabetes in the setting of chronic pancreatitis or after pancreatic resection

19

what is the function of PP (pancreatic polypeptide)?

regulates the expression of the hepatic insulin receptor gene

20

how do you diagnose factitious hypoglycemia?

low C peptide levels and high insulin
thus insulin:C peptide ratio >1

21

most common cause of acute vs chronic pancreatitis?

acute : biliary pancreatitis
chronic: alcohol