Pancreas

Nazik Al-Hashimi
Mind Map by Nazik Al-Hashimi, updated more than 1 year ago
Nazik Al-Hashimi
Created by Nazik Al-Hashimi over 6 years ago
4
0

Description

...

Resource summary

Pancreas
  1. Neoplasms
    1. Pancreatic Carcinoma (adenocarcinoma)
      1. Smoking
        1. Chronic pancreatitis
          1. (KRAS), p16, SMDA4 mutations
            1. initially: painLESS obstructive JAUNDICE (dark urine, icterus, steatorrhea)
              1. Later: painFUL d/t perineural invasion
                1. Diabetes (islets of langerhan destruction (endocrine))
                  1. Trousseau's sign: recurrent migratory thromboplebitis _ Renal vein thrombosis (mucin is thrombogenic)
                    1. Metastasis to mesenteric lymph nodes and LIVER
                      1. Treatment: Wipple's procedure + chemo (poor prognosis)
                        1. C 19.9 _ Ultrasound, CT
                          1. Mucinous
                            1. Cystic neoplasms
                              1. tall columnar mucin secreting cells
                                1. with surrounding ovarian type stroma
                                  1. Tail
                                    1. not connected to the ducts
                                      1. women ONLY
                            2. Acinar Cell Carcinoma
                              1. subcutaneous fat necrosis and panniculitis due to lipase
                                1. Whites
                              2. Intra-ductul papillary mucinous neoplasm (IPMN)
                                1. duct is dilated and filled with mucin
                                  1. HEAD
                                    1. NO ovarian type stroma
                              3. Endocrine tumors
                                1. Insulinoma
                                  1. Benign, solitory tumors from BETA CELLS
                                    1. Increase insulin
                                      1. WIPPLE'S TRIAD
                                        1. Symptoms of Hypoglycemia
                                          1. confusion, blurred vision, muscle weakness, sweating, palpitations
                                          2. relieved by glucose intake and accentuated by fasting
                                            1. Low blood glucose
                                      2. Gastrinoma
                                    2. Inflammatory lesions
                                      1. Acute Pancreatitis
                                        1. liquidative necrosis _ of exocrine pancreas ONLY
                                          1. NO DIABETES
                                            1. fever, nausea, vomiting, CONSTANT epigastric pain radiating to the back
                                            2. Fat necrosis (because Trypsin is activated first
                                              1. amylase and lipase break down fats >> FAs >> combine with Ca2+
                                                1. Saponification (Chaly White deposits on surface
                                                  1. Radio-OPAQUE on X-ray
                                                    1. Hypercalcemia and tetany
                                                2. investigation
                                                  1. amylase _ sensitive _ not specific (24-48 hours)
                                                    1. Lipase _ specific_ not sensitive (72-96 hours)
                                                      1. CT >> fat and liquifactive necrosis
                                                      2. Complication
                                                        1. ARDS
                                                          1. secondary bacterial infection w/ sepsis
                                                            1. hypovolemic shock
                                                              1. acute tubular necrosis
                                                                1. acute renal failure
                                                              2. DIC
                                                              3. Pseudocysts
                                                                1. Hemorrhage
                                                                2. GET SMASHED
                                                                  1. Alcohol
                                                                    1. contracts sphincter of Oddi _ alcohol increases protein concentration >> increased this thickness of pancreatic enzymes >> obstruction
                                                                      1. premature activation of the enzymes INSIDE the pancreas
                                                                    2. Gallstones
                                                                      1. acinar cell injury and duct obstruction
                                                                      2. HypERcalcemia
                                                                        1. Trauma
                                                                          1. Scorpion toxin
                                                                            1. mumps
                                                                              1. Autoimmune
                                                                                1. Steroids
                                                                                  1. hyperlipidemia
                                                                                    1. Endoscopic Retrograde Colangiocreatography
                                                                                      1. Drugs
                                                                                    2. Chronic Pancreatitis
                                                                                      1. Chronic bouts of acute pancreatitis
                                                                                        1. pancreatic parenchyma becomes fibrotic and atrophies
                                                                                          1. no production of pancreatic enzymes (NO INTRALUMINAL HYDROLYSIS)
                                                                                            1. malabsorption (corrected by enzyme supplements) / steatorrhea
                                                                                              1. No Vit D
                                                                                                1. Hypercalcemia
                                                                                                  1. Cardiac arythmia
                                                                                              2. Obstruction
                                                                                                1. JAUNDICE
                                                                                              3. Reduced number and size of acini dilation of the main duct
                                                                                                1. dystrophic calcification
                                                                                                2. alcohol
                                                                                                  1. toxin
                                                                                                    1. oxidative stress
                                                                                                  2. CFTR
                                                                                                    1. CT
                                                                                                      1. Pseudocysts
                                                                                                        1. fluid filled cavities NOT lined by epithelium - fibrous scar
                                                                                                          1. Pancreatic insufficiency
                                                                                                            1. islets of langerhans are USUALLY spared but if they're damaged
                                                                                                              1. Diabetes
                                                                                                              2. pain ATTACKS from perineural fibrosis
                                                                                                                1. Cancer
                                                                                                                  1. pleural effusion
                                                                                                                2. Congenital
                                                                                                                  1. Pancreas divisor
                                                                                                                    1. Ectopic Pancreatic tissue in GIT
                                                                                                                    2. Autoimmune Pancreatitis (Lymphoplasmacytic sclerosing pancreatitis / duct-destructive pancreatitis
                                                                                                                      1. Type 1: lymphoplasmacytic infiltrate centered around LARGE & medium sized interlobular ducts
                                                                                                                        1. Periductual & perivenular fibrosis
                                                                                                                          1. OBLITERATIVE PHLEBITIS (arteries are spared)
                                                                                                                            1. IgG4 plasma cells
                                                                                                                              1. Male in 60's
                                                                                                                              2. Type 2: lymphoplasmacytitc infiltrate centered around small ducts
                                                                                                                                1. Granulytic epithelial lesions with partial/complete duct obstruction/ obliteration
                                                                                                                                  1. NO IgG4
                                                                                                                                    1. both genders, 40's
                                                                                                                                    2. JAUNDICE, abdominal pain, MASS-LIKE LESION (differentiate it from Chronic pancreatitis), Diabetes Mellitus, weight loss
                                                                                                                                      1. increase pancreatic enzymes and IgG4
                                                                                                                                        1. auto-Ab (ANA, lactoferrin (ALF) , anti-carbonic anhydrase I (ACA-II), Rheumatoid factor (Rh) )
                                                                                                                                        Show full summary Hide full summary

                                                                                                                                        Similar

                                                                                                                                        ameoba
                                                                                                                                        david doran
                                                                                                                                        Last WYNTK
                                                                                                                                        prosscol000
                                                                                                                                        Chapter 9 quiz
                                                                                                                                        kbewley9
                                                                                                                                        Rounding to nearest 10, 100 and 1000 L1
                                                                                                                                        Lee Holness
                                                                                                                                        الفرق بين المناعة السلبيه والمناعة الايجابيه
                                                                                                                                        ‫فطوم خليفه‬‎
                                                                                                                                        TEORIA COSMOGONICA
                                                                                                                                        Mateo Rojasniño
                                                                                                                                        La inserción de México en la economía mundial
                                                                                                                                        Jose Manuel Romero Valencia
                                                                                                                                        French Future Tense Verbs
                                                                                                                                        PEACEout
                                                                                                                                        Long-term responses to Earthquakes
                                                                                                                                        Lukas Lie
                                                                                                                                        Break-even Y9 Business
                                                                                                                                        Christina Situ