Pathology Chapter 1 Exam Study Guide
Latest Updated 2024/2025
What are the two divisions of the pancreas and what do they do?
- ansExocrine: secrete enzymes for digestion
Endocrine: secrete hormones into blood
Where is pancreas in relation to duodeum? - ansSlightly
posterior
What is an annular pancreas? - ansDevelopmental malformation
in which the pancreas forms a ring around the duodenum; risk of
duodenal obstruction
Acute pancreatitis definition - ansInflammation and hemorrhage
of the pancreas due to autodigestion of pancreatic parenchyma
by pancreatic enzymes that are prematurely activated
When do the pancreatic enzymes get activated normally? -
ansWhen they reach the duodenum
What causes acute pancreatitis? - ansPremature activation of
pancreatic enzymes before they reach the duodenum; trypsin
activation is the inciting factor
What are the two types of necrosis seen in acute pancreatitis? -
ansLiquefactive hemorrhagic necrosis of the pancreas and fat
necrosis of the peripancreatic fat
What are the two most common causes of acute pancreatitis and
other less common causes? - ansMost common: alcohol and
gallstones
Less common: trauma (child in MVC), hypercalcemia,
hyperlipidemia, drugs, scorpion stings, mumps, rupture of
posterior duodenal ulcer
How does hypercalcemia lead to acute pancreatitis? -
ansCalcium activates enzymes!
,Pathology Chapter 1 Exam Study Guide
Latest Updated 2024/2025
How does alcohol lead to acute pancreatitis? - ansAlcohol
contracts the sphincter of Oddi, blocking enzyme release from
the pancreas
How do gallstones lead to acute pancreatitis? - ansBlock
ampulla, blocking drainage of pancreas
Name five clinical features of pancreatitis - ans1. Epigastric
abdominal pain radiating to the back
2. Nausea and vomitig
3. Periumbilical and flank hemorrhage (bc necrosis spreads into
the periumbilical soft tissue and retroperitoneum)
4. Elevated serum lipase and amylase (lipase more specific for
pancreatic damage)
5. Hypocalcemia (Calcium is used during saponification in fat
necrosis)
Where is amylase released from? - ansSalivary glands and
pancreas
What is a poor prognostic indicator of acute pancreatitis? -
ansHypocalcemia (calcium is consumed during saponification in
fat necrosis)
Name four complications of acute pancreatitis - ans1. Shock
2. Pancreatic pseudocyst (which can rupture)
3. Pancreatic abscess
4. DIC and ARDS
How is shock a complication of acute pancreatitis? -
ansPeripancreatic hemorrhage and fluid sequestration
How does pancreatic pseudocyst present? - ansAbdominal mass
with persistently elevated amylase
, Pathology Chapter 1 Exam Study Guide
Latest Updated 2024/2025
What is a further complication of a pancreatic pseudocyst? -
ansIt can rupture and release enzymes into the abdominal cavity
and hemorrhage
How does a pseudocyst as a complication of acute pancreatitis
form? - ansFormed 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? - ansE. coli
How does pancreatic abscess as a complication of acute
pancreatitis present? - ansAbdominal pain, high fever,
persistently elevated amylase
How are DIC and ARDS complication of acute pancreatitis? -
ansDIC- 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? - ansFibrosis of pancreatic
parenchyma, most often secondary to recurrent acute
pancreatitis
What is most common cause of chronic pancreatitis? -
ansRecurrent 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? -
ansEpigastric abdominal pain radiating to the back with
pancreatic insufficiency
What are sequelae of pancreatic insufficiency in chronic
pancreatitis? - ansMalabsorption (insufficient pancreatic
Latest Updated 2024/2025
What are the two divisions of the pancreas and what do they do?
- ansExocrine: secrete enzymes for digestion
Endocrine: secrete hormones into blood
Where is pancreas in relation to duodeum? - ansSlightly
posterior
What is an annular pancreas? - ansDevelopmental malformation
in which the pancreas forms a ring around the duodenum; risk of
duodenal obstruction
Acute pancreatitis definition - ansInflammation and hemorrhage
of the pancreas due to autodigestion of pancreatic parenchyma
by pancreatic enzymes that are prematurely activated
When do the pancreatic enzymes get activated normally? -
ansWhen they reach the duodenum
What causes acute pancreatitis? - ansPremature activation of
pancreatic enzymes before they reach the duodenum; trypsin
activation is the inciting factor
What are the two types of necrosis seen in acute pancreatitis? -
ansLiquefactive hemorrhagic necrosis of the pancreas and fat
necrosis of the peripancreatic fat
What are the two most common causes of acute pancreatitis and
other less common causes? - ansMost common: alcohol and
gallstones
Less common: trauma (child in MVC), hypercalcemia,
hyperlipidemia, drugs, scorpion stings, mumps, rupture of
posterior duodenal ulcer
How does hypercalcemia lead to acute pancreatitis? -
ansCalcium activates enzymes!
,Pathology Chapter 1 Exam Study Guide
Latest Updated 2024/2025
How does alcohol lead to acute pancreatitis? - ansAlcohol
contracts the sphincter of Oddi, blocking enzyme release from
the pancreas
How do gallstones lead to acute pancreatitis? - ansBlock
ampulla, blocking drainage of pancreas
Name five clinical features of pancreatitis - ans1. Epigastric
abdominal pain radiating to the back
2. Nausea and vomitig
3. Periumbilical and flank hemorrhage (bc necrosis spreads into
the periumbilical soft tissue and retroperitoneum)
4. Elevated serum lipase and amylase (lipase more specific for
pancreatic damage)
5. Hypocalcemia (Calcium is used during saponification in fat
necrosis)
Where is amylase released from? - ansSalivary glands and
pancreas
What is a poor prognostic indicator of acute pancreatitis? -
ansHypocalcemia (calcium is consumed during saponification in
fat necrosis)
Name four complications of acute pancreatitis - ans1. Shock
2. Pancreatic pseudocyst (which can rupture)
3. Pancreatic abscess
4. DIC and ARDS
How is shock a complication of acute pancreatitis? -
ansPeripancreatic hemorrhage and fluid sequestration
How does pancreatic pseudocyst present? - ansAbdominal mass
with persistently elevated amylase
, Pathology Chapter 1 Exam Study Guide
Latest Updated 2024/2025
What is a further complication of a pancreatic pseudocyst? -
ansIt can rupture and release enzymes into the abdominal cavity
and hemorrhage
How does a pseudocyst as a complication of acute pancreatitis
form? - ansFormed 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? - ansE. coli
How does pancreatic abscess as a complication of acute
pancreatitis present? - ansAbdominal pain, high fever,
persistently elevated amylase
How are DIC and ARDS complication of acute pancreatitis? -
ansDIC- 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? - ansFibrosis of pancreatic
parenchyma, most often secondary to recurrent acute
pancreatitis
What is most common cause of chronic pancreatitis? -
ansRecurrent 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? -
ansEpigastric abdominal pain radiating to the back with
pancreatic insufficiency
What are sequelae of pancreatic insufficiency in chronic
pancreatitis? - ansMalabsorption (insufficient pancreatic
