ABSITE - Pancreas - Questions
All of the following inherited familial syndromes are associated with an increased incidence
of pancreatic endocrine neoplasms besides:
A. Von Hippel-Lindau (VHL) syndrome.
B. Tuberous sclerosis (TSC).
C. More than one endocrine neoplasia type 1 (MEN-1).
D. Peutz-Jeghers syndrome (PJS).
E. Neurofibromatosis (NF-1). - ANSPeutz-Jeghers syndrome (PJS).
Correct.
The majority of pancreatic endocrine neoplasms are sporadic. Some of them, however, arise
as a part of inherited familial syndromes which include MEN-1, VHL syndrome, NF-1, and
TSC. MEN-1 is associated with gastrinoma, at the same time as NF-1 is associated with
somatostatinomas. VHL and TSC are each related to extended pancreatic endocrine
neoplasms. PJS is characterized via the development of benign hamartomatous polyps
inside the gastrointestinal tract. It is associated with an multiplied chance of growing
carcinomas of the pancreas, liver, lungs, breast, ovaries, uterus, testicles, and other organs.
Which of the following statements is real regarding pseudocysts in chronic pancreatitis?
A. Pseudocysts, despite the fact that not unusual following an episode of acute pancreatitis,
rarely occur in patients with continual pancreatitis.
B. Recurrence of a pancreatic pseudocyst after aspiration implies an ongoing communique
with the pancreatic duct.
C. In patients with continual pancreatitis and a pseudocyst, adequate drainage of the
pseudocyst will commonly bring about huge ache comfort and decreased narcotic
necessities.
D. Percutaneous drainage correctly treats pancreatic pseudocysts in almost all instances. -
ANSRecurrence of a pancreatic pseudocyst after aspiration implies an ongoing
communication with the pancreatic duct.
Correct.
Pancreatic pseudocysts are a common complication of chronic pancreatitis. The underlying
ductal abnormalities in patients with chronic pancreatitis make pseudocysts less likely to
regress spontaneously in these sufferers. Pseudocysts may be an crucial additional purpose
of pain in patients with continual pancreatitis, however treatment of the pseudocyst rarely
leads to complete ache alleviation. Ideally, the pancreatic ductal anatomy ought to be
described prior to any strive at treatment. A pseudocyst that recurs after percutaneous
drainage has by means of definition an ongoing verbal exchange with the pancreatic ductal
system and is satisfactory treated by means of operative inner drainage. This system can be
blended with a ductal drainage process if indicated to deal with the patient's chronic
pancreatitis.
, A 35-year-old lady is evaluated for a seizure sickness, intellectual obtundation, and persona
trade. The findings on physical examination are ordinary. The fasting serum glucose is 44
mg/dL. Other serum values are normal. An insulin-to-glucose (I:G) ratio of 0.Five turned into
documented after 28 hours of fasting. Symptoms of intellectual obtundation advanced
simultaneously and have been reversed by means of oral management of glucose.
Endoscopic ultrasonography confirmed a 1.2-cm mass in the head of the pancreas.
Appropriate management consists of which of the subsequent?
A. Long-term administration of octreotide
B. Surgical enucleation of the tumor
C. Pancreaticoduodenectomy
D. Total pancreatectomy - ANSSurgical enucleation of the tumor
Correct.
Management of an insulinoma is surgical in nearly all cases. Insulinomas are flippantly
dispensed in the pancreas; about one 1/3 are located inside the head and uncinate system,
one third in the body of the gland, and one 1/3 inside the tail of the gland. Ninety percent of
sufferers have a benign solitary adenoma amenable to surgical remedy. Small benign
insulinomas now not close to the pancreatic duct can be removed by means of enucleation,
unbiased of area inside the gland. In the body and tail of the pancreas, insulinomas large
than 2 cm in diameter and those close to the pancreatic duct are most generally excised by
means of a distal pancreatectomy. Large insulinomas deep inside the head of pancreas or
uncinate technique of the pancreas might not be amenable to local excision and might
necessitate pancreaticoduodenectomy.
Which of the following genetic changes is discovered in excessive frequency (50% or
greater) in patients with pancreatic most cancers?
A.
Disorders of DNA mismatch-repair genes
B.
Absence of the tumor-suppressor gene DPC4
C.
Point mutation of the oncogene p53
D.
Activation of the oncogene p16 - ANSAbsence of the tumor-suppressor gene DPC4
Correct.
The genes concerned in the pathogenesis of pancreatic most cancers may be divided into
three classes: (a) tumor-suppressor genes, (b) oncogenes, and (c) DNA mismatch-repair
genes. Tumor-suppressor genes usually function to manipulate cellular proliferation. When
these genes are inactivated by using genomic activities inclusive of mutation, deletion,
chromosome rearrangements, or mitotic recombination, their characteristic as boom
suppressors can be lost, and atypical boom law is the end result. The feature of p53 seems
to be inactivated in up to seventy five% of all pancreatic cancers. The p53 gene product is
the DNA-binding protein that acts as a cell cycle checkpoint and an inducer of apoptosis.
The DPC4 is a tumor-suppressor gene that has been diagnosed on chromosome 18q. The
All of the following inherited familial syndromes are associated with an increased incidence
of pancreatic endocrine neoplasms besides:
A. Von Hippel-Lindau (VHL) syndrome.
B. Tuberous sclerosis (TSC).
C. More than one endocrine neoplasia type 1 (MEN-1).
D. Peutz-Jeghers syndrome (PJS).
E. Neurofibromatosis (NF-1). - ANSPeutz-Jeghers syndrome (PJS).
Correct.
The majority of pancreatic endocrine neoplasms are sporadic. Some of them, however, arise
as a part of inherited familial syndromes which include MEN-1, VHL syndrome, NF-1, and
TSC. MEN-1 is associated with gastrinoma, at the same time as NF-1 is associated with
somatostatinomas. VHL and TSC are each related to extended pancreatic endocrine
neoplasms. PJS is characterized via the development of benign hamartomatous polyps
inside the gastrointestinal tract. It is associated with an multiplied chance of growing
carcinomas of the pancreas, liver, lungs, breast, ovaries, uterus, testicles, and other organs.
Which of the following statements is real regarding pseudocysts in chronic pancreatitis?
A. Pseudocysts, despite the fact that not unusual following an episode of acute pancreatitis,
rarely occur in patients with continual pancreatitis.
B. Recurrence of a pancreatic pseudocyst after aspiration implies an ongoing communique
with the pancreatic duct.
C. In patients with continual pancreatitis and a pseudocyst, adequate drainage of the
pseudocyst will commonly bring about huge ache comfort and decreased narcotic
necessities.
D. Percutaneous drainage correctly treats pancreatic pseudocysts in almost all instances. -
ANSRecurrence of a pancreatic pseudocyst after aspiration implies an ongoing
communication with the pancreatic duct.
Correct.
Pancreatic pseudocysts are a common complication of chronic pancreatitis. The underlying
ductal abnormalities in patients with chronic pancreatitis make pseudocysts less likely to
regress spontaneously in these sufferers. Pseudocysts may be an crucial additional purpose
of pain in patients with continual pancreatitis, however treatment of the pseudocyst rarely
leads to complete ache alleviation. Ideally, the pancreatic ductal anatomy ought to be
described prior to any strive at treatment. A pseudocyst that recurs after percutaneous
drainage has by means of definition an ongoing verbal exchange with the pancreatic ductal
system and is satisfactory treated by means of operative inner drainage. This system can be
blended with a ductal drainage process if indicated to deal with the patient's chronic
pancreatitis.
, A 35-year-old lady is evaluated for a seizure sickness, intellectual obtundation, and persona
trade. The findings on physical examination are ordinary. The fasting serum glucose is 44
mg/dL. Other serum values are normal. An insulin-to-glucose (I:G) ratio of 0.Five turned into
documented after 28 hours of fasting. Symptoms of intellectual obtundation advanced
simultaneously and have been reversed by means of oral management of glucose.
Endoscopic ultrasonography confirmed a 1.2-cm mass in the head of the pancreas.
Appropriate management consists of which of the subsequent?
A. Long-term administration of octreotide
B. Surgical enucleation of the tumor
C. Pancreaticoduodenectomy
D. Total pancreatectomy - ANSSurgical enucleation of the tumor
Correct.
Management of an insulinoma is surgical in nearly all cases. Insulinomas are flippantly
dispensed in the pancreas; about one 1/3 are located inside the head and uncinate system,
one third in the body of the gland, and one 1/3 inside the tail of the gland. Ninety percent of
sufferers have a benign solitary adenoma amenable to surgical remedy. Small benign
insulinomas now not close to the pancreatic duct can be removed by means of enucleation,
unbiased of area inside the gland. In the body and tail of the pancreas, insulinomas large
than 2 cm in diameter and those close to the pancreatic duct are most generally excised by
means of a distal pancreatectomy. Large insulinomas deep inside the head of pancreas or
uncinate technique of the pancreas might not be amenable to local excision and might
necessitate pancreaticoduodenectomy.
Which of the following genetic changes is discovered in excessive frequency (50% or
greater) in patients with pancreatic most cancers?
A.
Disorders of DNA mismatch-repair genes
B.
Absence of the tumor-suppressor gene DPC4
C.
Point mutation of the oncogene p53
D.
Activation of the oncogene p16 - ANSAbsence of the tumor-suppressor gene DPC4
Correct.
The genes concerned in the pathogenesis of pancreatic most cancers may be divided into
three classes: (a) tumor-suppressor genes, (b) oncogenes, and (c) DNA mismatch-repair
genes. Tumor-suppressor genes usually function to manipulate cellular proliferation. When
these genes are inactivated by using genomic activities inclusive of mutation, deletion,
chromosome rearrangements, or mitotic recombination, their characteristic as boom
suppressors can be lost, and atypical boom law is the end result. The feature of p53 seems
to be inactivated in up to seventy five% of all pancreatic cancers. The p53 gene product is
the DNA-binding protein that acts as a cell cycle checkpoint and an inducer of apoptosis.
The DPC4 is a tumor-suppressor gene that has been diagnosed on chromosome 18q. The
