Lisa Spiguel MD True or False The most common cause of chronic pancreatitis in the US is related to gallstones Which of the below proteins have been shown to be involved in the etiology of chronic pancreatitis ID: 998840
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1. PGY 101: Chapters 53 & 54Lisa Spiguel, MD
2. True or False: The most common cause of chronic pancreatitis in the US is related to gallstones.
3. Which of the below proteins have been shown to be involved in the etiology of chronic pancreatitis?SPINK-1 – Pancreatic secretory trypsin inhibitorCFTR – Cystic fibrosis transmembrane conductance regulatorC-Kit – Tyrosine kinase inhibitorA & BAll of the above
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5. True or False: Only 30% of acinar function must be lost prior to symptoms of steatorrhea appear.
6. Which of the following below is the most common complication of chronic pancreatitis?PainPseudocystPseudoaneurysmMesenteric Venous Thrombosis
7. A 55 yo man with a PMH of chronic pancreatitis presents to your clinic with complaints of abdominal discomfort, increased abdominal girth, and decreased appetite. On physical exam you not a non-pulsatile fullness in his epigastrium without signs of peritonitis. His CT scan is shown to the right. What is his diagnosis?Splenic artery aneurysmSplenic vein ThrombosisPancreatic adenocarcinomaPancreatic pseudocyst
8. True or False: Chronic pancreatitis is a risk factor for pancreatic adenocarcinoma, being proportionate with duration of diagnosis.
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10. A 62 yo male with chronic alcoholic pancreatitis presents to your clinic. He has been suffering with abdominal pain, steatorrhea, and weight loss for almost 3 years. He has seen multiple physicians with no help. He is on an extensive narcotic regimen and pancreatic enzyme replacement without success. You order a CT pancreatic protocol which is demonstrated below. Which surgical procedure would you offer this man?WhippleDistal pancreatectomyCentral pancreatectomyPeustow procedure
11. A 62 yo male with chronic alcoholic pancreatitis presents to your clinic. He has been suffering with abdominal pain, steatorrhea, and weight loss for almost 3 years. He has seen multiple physicians with no help. He is on an extensive narcotic regimen and pancreatic enzyme replacement without success. You order a CT pancreatic protocol which is demonstrated below. However it also demonstrates excessive chronic pancreatitic changes in the pancreatic head. Which surgical procedure would you offer this man?WhippleDistal pancreatectomyFrey procedurePeustow procedure
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13. PuestowFrey
14. WhippleFryeBeger
15. Distal Pancreatectomy
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17. 55 yo male presents to his PCP with a 2 month history of some mild upper abdominal pain, and new onset yellowing of the skin. His PCP orders a CT abdomen and pelvis below. What is your diagnosis?CholedocholithiasisPseudoaneurysmPancreatic adenocarcinomaChronic Pancreatitis
18. Which of the following below is not a risk factor for pancreatic cancer?TobaccoAgeBRCA 2+ carrierHigh fiber diet
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20. True of False: 20 % of pancreatic cancer are caused by Familial predisposition syndromes.
21. Which of the below genes is not associated with pancreatic cancer?BRCA 2PRSSlSTKllVEGF
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23. Which of the below Oncogenes has be found to be altered in patients with pancreatic adenocarcinoma?P53DPC4BRCA 2K-ras
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25. Which of the tumor markers below is elevated in pancreatic adenocarcinoma?CA 125CA 19-9CEAAFP
26. 55 yo male presents to his PCP with a 2 month history of some mild upper abdominal pain, his PCP orders a CT abdomen pelvis as demonstrated below. What is the best surgical treatment option?PancreaticoduodenectomySplenectomyCentral pancreatectomyDistal pancreatectomy
27. 55 yo male presents to his PCP with a 2 month history of some mild upper abdominal pain, his PCP orders a CT abdomen pelvis as demonstrated below. What is the best surgical treatment option?PancreaticoduodenectomySplenectomyCentral pancreatectomyDistal pancreatectomy
28. Distal PancreatectomyWhipple
29. A 64 yo male is recently diagnosed with pancreatic adenocarcinoma after a work up of back pain and new onset jaundice. His CT is demonstrated below. What is your definitive plan?Pancreaticoduodenectomy followed by Adjuvant chemo-XRTNeoadjuvant chemo-XRT followed by plan for pancreaticoduodenectomy if clinical responseThis patient is a non-surgical candidatePancreaticoduodenectomy alone without adjuvant therapy
30. Which of the below is not a contraindication to pancreatic resection?Encroachment of the celiac plexusEncasement of superior mesenteric vesselsAbutting the portal veinAll of the above are contraindications
31. 5 yr survival rates for resectable pancreatic adenocarcinoma are? 5-10%10-15%15-20%20-25%
32. 57 yo male underwent an EGD for chronic abdominal pain that was not alleviated by antacids. Once the gastroenterologist entered the 2nd portion of the duodenum, he encountered the image below. What is your most likely diagnosis?Mucinous cystadenomaSerous cystadenomaIntraductal papillary mucinous neoplasmAmpullary adenocarcinoma
33. True or False: Intraductal papillary mucinous neoplasms contain ovarian-type stroma, unlike mucinous cystadenomas
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35. Which of the following is not an indication for Branch-duct type IPMN resection? Connection with main ductMural noduleGreater than 3 cmLocation in the distal body
36. True of False: All Serous Cystadenomas are benign and do not require resection.