Pathoma: Chapter 11 Questions and Answers
What is a poor prognostic indicator of acute pancreatitis? Correct Ans-Hypocalcemia
(calcium is consumed during saponification in fat necrosis)
Name four complications of acute pancreatitis Correct Ans-1. Shock
2. Pancreatic pseudocyst (which can rupture)
3. Pancreatic abscess
4. DIC and ARDS
How is shock a complication of acute pancreatitis? Correct Ans-Peripancreatic hemorrhage
and fluid sequestration
How does pancreatic pseudocyst present? Correct Ans-Abdominal mass with persistently
elevated amylase
What is a further complication of a pancreatic pseudocyst? Correct Ans-It can rupture and
release enzymes into the abdominal cavity and hemorrhage
How does a pseudocyst as a complication of acute pancreatitis form? Correct Ans-Formed
by fibrous tissue surrounding liquefactive necrosis and pancreatic enzymes (no true lining)
What is a cause of a pancreatic abscess as a complication of acute pancreatitis? Correct
Ans-E. coli
, Pathoma: Chapter 11 Questions and Answers
How does pancreatic abscess as a complication of acute pancreatitis present? Correct Ans-
Abdominal pain, high fever, persistently elevated amylase
How are DIC and ARDS complication of acute pancreatitis? Correct Ans-DIC- Pancreatic
enzymes can activate coagulation factors, leading to DIC
ARDS- Pancreatic enzymes can also eat up the alveolar-capillary interface, leading to ARDS
Definition of chronic pancreatitis? Correct Ans-Fibrosis of pancreatic parenchyma, most
often secondary to recurrent acute pancreatitis
What is most common cause of chronic pancreatitis? Correct Ans-Recurrent acute
pancreatitis; alcohol in adults and CF in children are the most common causes
*Note many cases are idiopathic
What are the two main clinical features of chronic pancreatitis? Correct Ans-Epigastric
abdominal pain radiating to the back with pancreatic insufficiency
What are sequelae of pancreatic insufficiency in chronic pancreatitis? Correct Ans-
Malabsorption (insufficient pancreatic enzymes) with steatorrhea and fat-soluble vitamin
(DAKE) deficiencies
, Pathoma: Chapter 11 Questions and Answers
Can you use amylase and lipase as serological markers of chronic pancreatitis? Why/Why not?
Correct Ans-No, because most of the pancreas is destroyed, so they aren't being made
anyways
What appears in pancreatic parenchyma on imaging of chronic pancreatitis? Correct Ans-
Dystrophic calcifications
What is revealed in contrast studies in chronic pancreatitis? Correct Ans-Chain of lakes
pattern due to dilation of pancreatic ducts
What is a late complication of chronic pancreatitis? Correct Ans-Secondary diabetes
mellitus due to destruction of islets
What is a risk associated with chronic pancreatitis? Correct Ans-Pancreatic carcinoma
What is the serological marker for pancreatic carcinoma? Correct Ans-CA 19-9
Adenocarcinoma arising from pancreatic ducts (not acini) Correct Ans-pancreatic
carcinoma
What do pancreatic acini do? Correct Ans-Make enzymes
, Pathoma: Chapter 11 Questions and Answers
When does pancreatic carcinoma usually present? Correct Ans-Late in disease (Avg age is
70 years old, so most commonly seen in elderly)
Two main presenting signs of pancreatic carcinoma Correct Ans-Epigastric abdominal pain,
weight loss, obstructive jaundice with pale stools and palpable gallbladder
What is the most common location of pancreatic carcinoma Correct Ans-Head of the
pancreas
What is associated with pancreatic carcinoma that arises in body/tail of pancreas? Correct
Ans-Secondary diabetes mellitus
Elderly female who is thin and suddenly presents with secondary diabetes mellitus Correct
Ans-Think about pancreatic carcinoma
What are the major risk factors for pancreatic carcinoma Correct Ans-Smoking and chronic
pancreatitis
How does Trousseau Syndrome (Migratory Thrombophlebitis) present? Correct Ans-
Swelling, erythema, tenderness in extremities
What percent of pancreatic carcinoma patients have Trousseau Syndrome? Correct Ans-
10%
What is a poor prognostic indicator of acute pancreatitis? Correct Ans-Hypocalcemia
(calcium is consumed during saponification in fat necrosis)
Name four complications of acute pancreatitis Correct Ans-1. Shock
2. Pancreatic pseudocyst (which can rupture)
3. Pancreatic abscess
4. DIC and ARDS
How is shock a complication of acute pancreatitis? Correct Ans-Peripancreatic hemorrhage
and fluid sequestration
How does pancreatic pseudocyst present? Correct Ans-Abdominal mass with persistently
elevated amylase
What is a further complication of a pancreatic pseudocyst? Correct Ans-It can rupture and
release enzymes into the abdominal cavity and hemorrhage
How does a pseudocyst as a complication of acute pancreatitis form? Correct Ans-Formed
by fibrous tissue surrounding liquefactive necrosis and pancreatic enzymes (no true lining)
What is a cause of a pancreatic abscess as a complication of acute pancreatitis? Correct
Ans-E. coli
, Pathoma: Chapter 11 Questions and Answers
How does pancreatic abscess as a complication of acute pancreatitis present? Correct Ans-
Abdominal pain, high fever, persistently elevated amylase
How are DIC and ARDS complication of acute pancreatitis? Correct Ans-DIC- Pancreatic
enzymes can activate coagulation factors, leading to DIC
ARDS- Pancreatic enzymes can also eat up the alveolar-capillary interface, leading to ARDS
Definition of chronic pancreatitis? Correct Ans-Fibrosis of pancreatic parenchyma, most
often secondary to recurrent acute pancreatitis
What is most common cause of chronic pancreatitis? Correct Ans-Recurrent acute
pancreatitis; alcohol in adults and CF in children are the most common causes
*Note many cases are idiopathic
What are the two main clinical features of chronic pancreatitis? Correct Ans-Epigastric
abdominal pain radiating to the back with pancreatic insufficiency
What are sequelae of pancreatic insufficiency in chronic pancreatitis? Correct Ans-
Malabsorption (insufficient pancreatic enzymes) with steatorrhea and fat-soluble vitamin
(DAKE) deficiencies
, Pathoma: Chapter 11 Questions and Answers
Can you use amylase and lipase as serological markers of chronic pancreatitis? Why/Why not?
Correct Ans-No, because most of the pancreas is destroyed, so they aren't being made
anyways
What appears in pancreatic parenchyma on imaging of chronic pancreatitis? Correct Ans-
Dystrophic calcifications
What is revealed in contrast studies in chronic pancreatitis? Correct Ans-Chain of lakes
pattern due to dilation of pancreatic ducts
What is a late complication of chronic pancreatitis? Correct Ans-Secondary diabetes
mellitus due to destruction of islets
What is a risk associated with chronic pancreatitis? Correct Ans-Pancreatic carcinoma
What is the serological marker for pancreatic carcinoma? Correct Ans-CA 19-9
Adenocarcinoma arising from pancreatic ducts (not acini) Correct Ans-pancreatic
carcinoma
What do pancreatic acini do? Correct Ans-Make enzymes
, Pathoma: Chapter 11 Questions and Answers
When does pancreatic carcinoma usually present? Correct Ans-Late in disease (Avg age is
70 years old, so most commonly seen in elderly)
Two main presenting signs of pancreatic carcinoma Correct Ans-Epigastric abdominal pain,
weight loss, obstructive jaundice with pale stools and palpable gallbladder
What is the most common location of pancreatic carcinoma Correct Ans-Head of the
pancreas
What is associated with pancreatic carcinoma that arises in body/tail of pancreas? Correct
Ans-Secondary diabetes mellitus
Elderly female who is thin and suddenly presents with secondary diabetes mellitus Correct
Ans-Think about pancreatic carcinoma
What are the major risk factors for pancreatic carcinoma Correct Ans-Smoking and chronic
pancreatitis
How does Trousseau Syndrome (Migratory Thrombophlebitis) present? Correct Ans-
Swelling, erythema, tenderness in extremities
What percent of pancreatic carcinoma patients have Trousseau Syndrome? Correct Ans-
10%
