Term
What are the risk factors for cholelithiasis
Risk factors for Cholesterol stones |
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Definition
Older Women
Native Americans
Diabetes
Clofibrate
Stasis
Weight Change
Cholesterol
Fat, Forty, Fertile, Females
Pathophys: Increase cholesterol or decrease bile salts
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Term
What type of stone is the most common in the US?
Who more commonly gets Brown and Black stones? |
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Definition
Cholesterol most common in US
Black: Hyperbilirubinemia
Brown: Orientals(infection or Stasis) |
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Term
| Complications of Gallstones |
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Definition
Cholecystitis
Coledocholithiasis
Pancreatitis
Ascending Cholangitis
Gallstone ileus
Gallbladder Carcinoma |
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Term
Common causes of Cholecystitis?
What is the pathophys of each cause? |
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Definition
Chemicals: Obstruction
Microbes: E.coli in 80% of cases of cholesistitis
Gallstones: Irritation and Obstruction
Ischemia: Inflammation, Distention/pressure |
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Term
| What is the histology of Acute and chronic Cholecystitis |
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Definition
Acute
Neutrophils
Ulcers
Edema
Chronic:
Lymphocytes
Fibrosis |
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Term
| What is the differential for outpouchings of the gallbladder mucosa penetrating the muscle wall? |
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Definition
Rokitansky-Aschoff Sinuses
Gallbladder Adenocarcinoma |
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Term
What patients commonly get Acute Acalculous Cholecystitis?
What is the cause in a young healthy person? |
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Definition
Common: ICU patient with ARDS or DIC
Young: Cocaine |
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Term
What is the gross and micro appearance of Cholesterolosis of the gallbladder?
Is it pathological?
Is high blood cholesterol a predisposign factor?
Is it common? |
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Definition
Micro: Foamy macrophages throughout mucosa
Gross: Strawberry Gallbladder
Path: Usually asymptomatic
Blood Cholesterol: Not a disposing factor
Common: 20% of gallbladders |
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Term
What tumors are indistinguishable from gallbladder Adenocarcinoma
What sex does gallbladder carcinoma affect?
What else is commonly found in the gallbladder if there is carcinoma? |
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Definition
Adeno of pancreatic or bile duct
Sex: More Women
Association: gallstones and carcinoma |
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Term
| What is the accessory duct of santorini? |
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Definition
| Accessory pancreatic duct from dorsal bud |
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Term
| What pancretic hormones are secreted by which islet cell? |
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Definition
Beta: Insulin
Alpha: Glucagon
D cells: Somatostatin |
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Term
Most common autosomal recessive mutation in caucasians?
What is it's pathogenesis in the Pancreas? |
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Definition
CF
Pathophys: increases viscosity in ducts causing obstrution leading to inflammation
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Term
| What are the symptoms, most common causes, lab results for pancreatitis? |
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Definition
Symptoms: Ab or Eipgastic pain radiating to the back
Causes: Gallstones, Alcohol
Lab: Amylase, Lipase, LDH |
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Term
Gross and Micro appearance of pancreatitis
What type of necrosis is common to the pancreas? |
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Definition
Gross:
Yellow
Firm/Edemaotus
Micro
Fat necrosis*
Inflammation
Parenchymal destruction |
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Term
Complications of acute pancreatitis?
How can pancreatitis cause Portal HPTN |
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Definition
Abcess
Pseudocyst
Hemorrhage
Shock
Portal HPTN: Portal and splenic vein thrombosis
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Term
What are the causes of chronic pancreatitis?
What is the first structure lost? |
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Definition
Alcohol
Hypercalcemia
Biliary Tract disease(including gallstones)
Structure: first one lost is the acini |
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Term
What are the major Pancreatic Tumors?
Which is most common?
How do they differ by location?
Which has zymogen granules within its cells? |
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Definition
Ductal Adenocarcimona(Most common 90%)
Most common in body
Acinar Cell Tumor: Zymogen granules
Islet Cell Tumor Most common in head |
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Term
| What is a Pancreatic Intraepithelial Neoplasia |
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Definition
| Precusor to pancreatic adenocarcinoma |
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Term
| What hormone production is most common in acinar cell carcinoma? |
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Definition
Insulinoma - Most common
Gastrinoma - 2nd most(Zollinger Ellison) |
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Term
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Definition
Pituitary
Parathyroid
Pancreas
(Zollinger-Ellison sometimes) |
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Term
| How is a pseudocyst differentiated from a cyst? |
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Definition
| Psedudocyst does not have an epithelium |
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Term
What are the signs of pancreatic adenocarcinoma?
What are the major gene mutations associated with pancreatic ductal adenocarcinoma? |
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Definition
Signs
Trousseau's Sign: Migratory Thrombophlebitis
Courvoiser's Sign: Gallbladder dilation
Pancreatitis: Epigastic w/ radiation to back
Pruritis
Painless Juandice
Diabetes Mellitis
Depression
Genes
K-Ras
P53
P16 |
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