3785615
Descrição
Mapa Mental por Nazik Al-Hashimi, atualizado more than 1 year ago
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Criado por Nazik Al-Hashimi
aproximadamente 9 anos atrás
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Pancreas
- Neoplasms
- Pancreatic Carcinoma
(adenocarcinoma)
- Smoking
- Chronic
pancreatitis
- (KRAS), p16,
SMDA4 mutations
- initially: painLESS obstructive JAUNDICE
(dark urine, icterus, steatorrhea)
- Later: painFUL d/t perineural invasion
- Diabetes (islets of
langerhan destruction
(endocrine))
- Trousseau's sign: recurrent migratory thromboplebitis
_ Renal vein thrombosis (mucin is thrombogenic)
- Metastasis to mesenteric lymph nodes and LIVER
- Treatment: Wipple's
procedure + chemo
(poor prognosis)
- C 19.9 _
Ultrasound,
CT
- Mucinous
- Cystic
neoplasms
- tall columnar
mucin
secreting cells
- with surrounding
ovarian type
stroma
- Tail
- not connected
to the ducts
- women ONLY
- women ONLY
- not connected
to the ducts
- Tail
- with surrounding
ovarian type
stroma
- tall columnar
mucin
secreting cells
- Cystic
neoplasms
- Acinar Cell
Carcinoma
- subcutaneous
fat necrosis
and
panniculitis
due to lipase
- Whites
- Whites
- subcutaneous
fat necrosis
and
panniculitis
due to lipase
- Intra-ductul
papillary mucinous
neoplasm (IPMN)
- duct is
dilated
and filled
with
mucin
- HEAD
- NO ovarian
type stroma
- NO ovarian
type stroma
- HEAD
- duct is
dilated
and filled
with
mucin
- Smoking
- Endocrine
tumors
- Insulinoma
- Benign,
solitory tumors
from BETA
CELLS
- Increase insulin
- WIPPLE'S TRIAD
- Symptoms of
Hypoglycemia
- confusion, blurred
vision, muscle weakness,
sweating, palpitations
- confusion, blurred
vision, muscle weakness,
sweating, palpitations
- relieved by
glucose intake
and accentuated
by fasting
- Low blood glucose
- Symptoms of
Hypoglycemia
- WIPPLE'S TRIAD
- Increase insulin
- Benign,
solitory tumors
from BETA
CELLS
- Gastrinoma
- Insulinoma
- Pancreatic Carcinoma
(adenocarcinoma)
- Inflammatory
lesions
- Acute
Pancreatitis
- liquidative necrosis _ of
exocrine pancreas ONLY
- NO DIABETES
- fever, nausea, vomiting, CONSTANT
epigastric pain radiating to the back
- NO DIABETES
- Fat necrosis (because
Trypsin is activated first
- amylase and lipase
break down fats >> FAs
>> combine with Ca2+
- Saponification (Chaly
White deposits on surface
- Radio-OPAQUE on X-ray
- Hypercalcemia and tetany
- Radio-OPAQUE on X-ray
- Saponification (Chaly
White deposits on surface
- amylase and lipase
break down fats >> FAs
>> combine with Ca2+
- investigation
- amylase _ sensitive _ not specific (24-48 hours)
- Lipase _ specific_ not sensitive (72-96 hours)
- CT >> fat and liquifactive necrosis
- amylase _ sensitive _ not specific (24-48 hours)
- Complication
- ARDS
- secondary bacterial
infection w/ sepsis
- hypovolemic shock
- acute
tubular
necrosis
- acute renal failure
- acute renal failure
- acute
tubular
necrosis
- DIC
- hypovolemic shock
- Pseudocysts
- Hemorrhage
- ARDS
- GET SMASHED
- Alcohol
- contracts sphincter of Oddi _ alcohol increases protein concentration
>> increased this thickness of pancreatic enzymes >> obstruction
- premature activation of the
enzymes INSIDE the pancreas
- premature activation of the
enzymes INSIDE the pancreas
- contracts sphincter of Oddi _ alcohol increases protein concentration
>> increased this thickness of pancreatic enzymes >> obstruction
- Gallstones
- acinar cell injury and
duct obstruction
- acinar cell injury and
duct obstruction
- HypERcalcemia
- Trauma
- Scorpion toxin
- mumps
- Autoimmune
- Steroids
- hyperlipidemia
- Endoscopic Retrograde
Colangiocreatography
- Drugs
- Alcohol
- liquidative necrosis _ of
exocrine pancreas ONLY
- Chronic
Pancreatitis
- Chronic bouts of
acute pancreatitis
- pancreatic parenchyma
becomes fibrotic and atrophies
- no production of
pancreatic enzymes
(NO INTRALUMINAL
HYDROLYSIS)
- malabsorption
(corrected by enzyme
supplements) /
steatorrhea
- No Vit D
- Hypercalcemia
- Cardiac arythmia
- Cardiac arythmia
- Hypercalcemia
- No Vit D
- malabsorption
(corrected by enzyme
supplements) /
steatorrhea
- Obstruction
- JAUNDICE
- JAUNDICE
- no production of
pancreatic enzymes
(NO INTRALUMINAL
HYDROLYSIS)
- Reduced number and size of
acini dilation of the main duct
- dystrophic calcification
- pancreatic parenchyma
becomes fibrotic and atrophies
- alcohol
- toxin
- oxidative stress
- oxidative stress
- toxin
- CFTR
- CT
- Pseudocysts
- fluid filled cavities NOT lined by epithelium - fibrous scar
- fluid filled cavities NOT lined by epithelium - fibrous scar
- Pancreatic insufficiency
- islets of langerhans are USUALLY spared but if they're damaged
- Diabetes
- Diabetes
- pain ATTACKS from perineural fibrosis
- Cancer
- pleural effusion
- Chronic bouts of
acute pancreatitis
- Acute
Pancreatitis
- Congenital
- Pancreas divisor
- Ectopic Pancreatic
tissue in GIT
- Pancreas divisor
- Autoimmune Pancreatitis (Lymphoplasmacytic
sclerosing pancreatitis / duct-destructive pancreatitis
- Type 1:
lymphoplasmacytic
infiltrate centered
around LARGE & medium
sized interlobular ducts
- Periductual & perivenular fibrosis
- OBLITERATIVE PHLEBITIS (arteries are spared)
- IgG4 plasma cells
- Male in 60's
- Periductual & perivenular fibrosis
- Type 2:
lymphoplasmacytitc
infiltrate centered
around small ducts
- Granulytic epithelial
lesions with
partial/complete duct
obstruction/ obliteration
- NO IgG4
- both genders, 40's
- Granulytic epithelial
lesions with
partial/complete duct
obstruction/ obliteration
- JAUNDICE, abdominal pain,
MASS-LIKE LESION
(differentiate it from Chronic
pancreatitis), Diabetes
Mellitus, weight loss
- increase pancreatic enzymes and IgG4
- auto-Ab (ANA, lactoferrin
(ALF) , anti-carbonic
anhydrase I (ACA-II),
Rheumatoid factor (Rh) )
- Type 1:
lymphoplasmacytic
infiltrate centered
around LARGE & medium
sized interlobular ducts
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