ABSITE Pancreas UPDATED Exam
Questions and CORRECT Answers
The pancreas is level with what vertebra? - CORRECT ANSWER - L1
Pancreas arterial supply and their origin - CORRECT ANSWER - The superior
pancreaticoduodenal artery arises from the gastroduodenal artery and divides into anterior and
posterior branches as it runs inferiorly within the pancreaticoduodenal groove. The inferior
pancreaticoduodenal artery arises from SMA. The neck, body, and tail receive arterial supply
from the splenic arterial system.
Rotation during pancreatic fusion - CORRECT ANSWER - Ventral posteriorly
Treatment for obstructive annular pancreas - CORRECT ANSWER - surgical bypass
through duodenojejunostomy is performed instead of dividing the pancreatic tissue, as this
annular pancreas has a pancreatic duct and its division will likely lead to pancreatic fistula
formation.
How are pancreatic enzymes activated? - CORRECT ANSWER - acinar cells synthesize
these proteases as inactive proenzymes that are stored as intracellular zymogen granules. With
stimulation of the pancreas, these proenzymes are secreted into the pancreatic duct and
eventually the duodenal lumen. The duodenal mucosa expresses enterokinase on its brush
boarder, which activates the zymogens.
main mediator of the secretion of water and bicarbonate from pancreas - CORRECT
ANSWER - Secretin from S cells
What stimulates secretin secretion? - CORRECT ANSWER - Decrease in duodenal pH
main mediator of the secretion of pancreatic enzymes - CORRECT ANSWER - CCK by I
cells
, Most common cause of acute pancreatitis - CORRECT ANSWER - Gall stones
Treatment for pancreatic divisum - CORRECT ANSWER - Endoscopic retrograde
cholangiopancreatography (ERCP) with minor papillotomy and stenting
Describe acute pancreatitis pain - CORRECT ANSWER - Constant epigastric pain that
radiates to the back
Grey Turner and Cullen signs - CORRECT ANSWER - flank and periumbilical
ecchymosis respectively, both are indicative of retroperitoneal bleeding associated with severe
pancreatitis.
Diagnosis of acute pancreatitis - CORRECT ANSWER - two of the following three:
1) abdominal pain consistent with AP
2) a threefold or higher elevation of serum amylase or lipase
3) characteristics findings of pancreatitis by imaging.
95% PPV for acute biliary pancreatitis in the setting of high amylase / lipase - CORRECT
ANSWER - elevation of alanine aminotransferase levels
presence of gallstones on US
define severe pancreatitis - CORRECT ANSWER - presence of local pancreatic
complications (necrosis, abscess, or pseudocyst) or any evidence of organ failure > 48 hrs
cornerstones of treating acute pancreatitis - CORRECT ANSWER - aggressive fluid
resuscitation with isotonic crystalloid solution, pain control, and early nutrition.
Why should patients with acute pancreatitis be placed on continuous pulse oximetry? -
CORRECT ANSWER - because one of the most common systemic complications of AP is
hypoxemia caused by the acute lung injury associated with this disease.
Questions and CORRECT Answers
The pancreas is level with what vertebra? - CORRECT ANSWER - L1
Pancreas arterial supply and their origin - CORRECT ANSWER - The superior
pancreaticoduodenal artery arises from the gastroduodenal artery and divides into anterior and
posterior branches as it runs inferiorly within the pancreaticoduodenal groove. The inferior
pancreaticoduodenal artery arises from SMA. The neck, body, and tail receive arterial supply
from the splenic arterial system.
Rotation during pancreatic fusion - CORRECT ANSWER - Ventral posteriorly
Treatment for obstructive annular pancreas - CORRECT ANSWER - surgical bypass
through duodenojejunostomy is performed instead of dividing the pancreatic tissue, as this
annular pancreas has a pancreatic duct and its division will likely lead to pancreatic fistula
formation.
How are pancreatic enzymes activated? - CORRECT ANSWER - acinar cells synthesize
these proteases as inactive proenzymes that are stored as intracellular zymogen granules. With
stimulation of the pancreas, these proenzymes are secreted into the pancreatic duct and
eventually the duodenal lumen. The duodenal mucosa expresses enterokinase on its brush
boarder, which activates the zymogens.
main mediator of the secretion of water and bicarbonate from pancreas - CORRECT
ANSWER - Secretin from S cells
What stimulates secretin secretion? - CORRECT ANSWER - Decrease in duodenal pH
main mediator of the secretion of pancreatic enzymes - CORRECT ANSWER - CCK by I
cells
, Most common cause of acute pancreatitis - CORRECT ANSWER - Gall stones
Treatment for pancreatic divisum - CORRECT ANSWER - Endoscopic retrograde
cholangiopancreatography (ERCP) with minor papillotomy and stenting
Describe acute pancreatitis pain - CORRECT ANSWER - Constant epigastric pain that
radiates to the back
Grey Turner and Cullen signs - CORRECT ANSWER - flank and periumbilical
ecchymosis respectively, both are indicative of retroperitoneal bleeding associated with severe
pancreatitis.
Diagnosis of acute pancreatitis - CORRECT ANSWER - two of the following three:
1) abdominal pain consistent with AP
2) a threefold or higher elevation of serum amylase or lipase
3) characteristics findings of pancreatitis by imaging.
95% PPV for acute biliary pancreatitis in the setting of high amylase / lipase - CORRECT
ANSWER - elevation of alanine aminotransferase levels
presence of gallstones on US
define severe pancreatitis - CORRECT ANSWER - presence of local pancreatic
complications (necrosis, abscess, or pseudocyst) or any evidence of organ failure > 48 hrs
cornerstones of treating acute pancreatitis - CORRECT ANSWER - aggressive fluid
resuscitation with isotonic crystalloid solution, pain control, and early nutrition.
Why should patients with acute pancreatitis be placed on continuous pulse oximetry? -
CORRECT ANSWER - because one of the most common systemic complications of AP is
hypoxemia caused by the acute lung injury associated with this disease.
