MCCN SDAP X - Pathophysiology Exam
3 Blueprint questions and answers
what pancreatic cancer has in common with all malignant conditions - correct answer
✔✔caused by DNA mutation, abnormal/uncontrolled tissue growth, loss of differentiation,
tumors are invasive (metastatic; do not stay within boundaries), immortality, loss of
cohesion/adhesion.
why is pancreatic cancer often diagnosed in its later stages? - correct answer ✔✔no early
warning symptoms and no reliable diagnostic tests -> often reported as Grade IV, stage 3/4
adenocarcinoma
What is the relationship between stage and prognosis of (pancreatic) cancer? - correct answer
✔✔The lower the stage (Stage 0 in situ or Stage 1) the better the prognosis. The higher the
stage (Stage 4), the worse the prognosis. Pancreatic cancer is one of the most deadly
malignancies, and few are living one year after diagnosis
most common site of pancreatic cancer - correct answer ✔✔head of pancreas
s/s of pancreatic cancer (relation to tumor location) - correct answer ✔✔LUQ/epigastic pain
(10/10), pain referred to back, jaundice (obstruction)
How is pancreatic cancer diagnosed? - correct answer ✔✔Pancreatic enzymes (amylase, lipase)
elevated if obstruction is present, bilirubin levels elevated if bile flow is obstructed;
Definitive diagnosis for pancreatic cancer - correct answer ✔✔biopsy via gastric endoscopy
(needle passes through stomach wall into pancreas)
, pancreatic cancer tumor marker - correct answer ✔✔CEA, Ca 19-9
Treatment for pancreatic cancer - correct answer ✔✔Chemotherapy, radiation. Surgery if
appropriate for localized tumors.
common etiologies for pancreatitis - correct answer ✔✔viral, bacterial, trauma, drug side
effects, heavy alcohol consumption, gallstones
cholelithiasis and pancreatitis - correct answer ✔✔Gallstones can be released from the
gallbladder and present in the ducts leading to the duodenum. If the gallstone gets stuck at the
Ampula of Vater, it can obstruct bile flow causing it to backflow into pancreas causing
inflammation.
Why pancreatic cancer could present with pancreatitis - correct answer ✔✔s/s similar; any
obstruction at the head of the pancreas causes enzymes of the pancreas to become backed up,
which leads to autodigestion within the pancreas, resulting in inflammation (pancreatitis)
CLASSACT of pancreatitis - correct answer ✔✔C -
L - LUQ of abd, epigastric pain radiation to back
A - eating and laying down
S - 10/10 on pain scale
S - often after meal
A - nausea and vomiting
C-
T - abrupt onset after meal or alcoholic binge
Rationale for S/S of pancreatitis - correct answer ✔✔All these S/S are caused by enzyme back
flow due to obstruction and autodigestion causing inflammation.
3 Blueprint questions and answers
what pancreatic cancer has in common with all malignant conditions - correct answer
✔✔caused by DNA mutation, abnormal/uncontrolled tissue growth, loss of differentiation,
tumors are invasive (metastatic; do not stay within boundaries), immortality, loss of
cohesion/adhesion.
why is pancreatic cancer often diagnosed in its later stages? - correct answer ✔✔no early
warning symptoms and no reliable diagnostic tests -> often reported as Grade IV, stage 3/4
adenocarcinoma
What is the relationship between stage and prognosis of (pancreatic) cancer? - correct answer
✔✔The lower the stage (Stage 0 in situ or Stage 1) the better the prognosis. The higher the
stage (Stage 4), the worse the prognosis. Pancreatic cancer is one of the most deadly
malignancies, and few are living one year after diagnosis
most common site of pancreatic cancer - correct answer ✔✔head of pancreas
s/s of pancreatic cancer (relation to tumor location) - correct answer ✔✔LUQ/epigastic pain
(10/10), pain referred to back, jaundice (obstruction)
How is pancreatic cancer diagnosed? - correct answer ✔✔Pancreatic enzymes (amylase, lipase)
elevated if obstruction is present, bilirubin levels elevated if bile flow is obstructed;
Definitive diagnosis for pancreatic cancer - correct answer ✔✔biopsy via gastric endoscopy
(needle passes through stomach wall into pancreas)
, pancreatic cancer tumor marker - correct answer ✔✔CEA, Ca 19-9
Treatment for pancreatic cancer - correct answer ✔✔Chemotherapy, radiation. Surgery if
appropriate for localized tumors.
common etiologies for pancreatitis - correct answer ✔✔viral, bacterial, trauma, drug side
effects, heavy alcohol consumption, gallstones
cholelithiasis and pancreatitis - correct answer ✔✔Gallstones can be released from the
gallbladder and present in the ducts leading to the duodenum. If the gallstone gets stuck at the
Ampula of Vater, it can obstruct bile flow causing it to backflow into pancreas causing
inflammation.
Why pancreatic cancer could present with pancreatitis - correct answer ✔✔s/s similar; any
obstruction at the head of the pancreas causes enzymes of the pancreas to become backed up,
which leads to autodigestion within the pancreas, resulting in inflammation (pancreatitis)
CLASSACT of pancreatitis - correct answer ✔✔C -
L - LUQ of abd, epigastric pain radiation to back
A - eating and laying down
S - 10/10 on pain scale
S - often after meal
A - nausea and vomiting
C-
T - abrupt onset after meal or alcoholic binge
Rationale for S/S of pancreatitis - correct answer ✔✔All these S/S are caused by enzyme back
flow due to obstruction and autodigestion causing inflammation.
