Pancreatic pathology – Flashcards

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question
You are performing an US study to rule out the presence of a pancreatic tumor. What is the most commonly occurring malignant tumor of the pancreas? A. Cystadenocarcinoma B. Insulinoma C. Adenocarcinoma D. Gastrinoma E. Klatskin tumor
answer
C.
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Which of the following is a risk factor for the development of pancreatic cancer? A. Smoking B. High-fat diet C. Diabetes D. Chronic pancreatitis E. All of the above
answer
E. (risk factors include all listed as well as prior peptic ulcer surgery, cholecystectomy, and occupational exposure to benzidine and gasoline derivatives.)
question
You are scanning a 52 YO male with a history of alcohol abuse. US findings include a hyperechoic mass in the head of the pancreas, dilation of the pancreatic and CBD, and diffuse calcification within the pancreas. Which of the following conditions is most likely present? A. Acute pancreatitis B. Chronic pancreatitis C. Adenocarcinoma D. Cystadenocarcinoma E. Islet cell tumor
answer
B. (It can be difficult to differentiate btw chronic pancreatitis and adenocarcinoma when chronic pancreatitis presents as a focal mass or a pseudocyst accompanies adenocarcinoma. The presence of calcification within the pancreas implicates chronic pancreatitis. A smooth tapering of a dilated CBD is another clue indicating a benign condition.)
question
You have a patient who is scheduled for pancreatic surgery following US and CT eval. What is the surgical procedure of choice for pancreatic cancer? A. Whipple procedure B. Cholecystectomy and pancreatectomy C. Pancreatic transplant D. Choledochojejeunostomy E. Wirsung procedure
answer
A.
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You have been asked to aid in staging of pancreatic cancer. Which procedure is most accurate in staging pancreatic adenocarcinoma? A. Ab US B. Endoscopic US C. CT D. MRI E. Plain film X-ray
answer
C. (CT is considered to be superior for staging of pancreatic cancers because it can better visualize peripancreatic fat infiltration, vascular encasement, lymph node enlargement, and mets. Endoscopic US is excellent at staging small ampullopancreatic tumors but cannot routinely detect mets.)
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A patient has been referred to US to rule out the presence of pancreatic cancer. The cancer is most likely to be located in which part of the pancreas? A. Head B. Neck C. uncinate process D. Body E. Tail
answer
A. (Adenocarcinoma is the most common form of pancreatic cancer and is most commonly located in the head of the pancreas.)
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What is the most common US appearance of pancreatic adenocarcinoma? A. Hyperechoic mass B. Hypoechoic mass C. Cystic mass D. Calcified mass E. Complex mass with both cystic and solic components
answer
B. (Adenocarcinoma most commonly presents as a hypoechoic mass in the head of the pancreas. hyperechoic masses may occur in cases with concomitant chronic pancreatitis.)
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Which of the following is an endocrine tumor? A. Adenocarcinoma B. Islet cell tumor C. Cystadenocarcinoma D. Lymphangioma E. Pancreaticoblastoma
answer
B.
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You are requested to perform an AB US on a patient to evaluate for complications of pancreatitis. What should you look for? A. pseudoaneurysm B. Pseudocyst C. Phlegmon D. Abscess E. All of the above
answer
E
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You have just discovered a pancreatic mass suspicious for adenocarcinoma in a patient with wt loss and ab pain. What associated findings should you look for? A. Lymphadenopathy B. Liver mets C. Portal Vein aneurysm D. Aortic aneurysm E. A & B
answer
E.
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You are scanning a patient with increased pancreatic enzymes and WBC count. Which of the following conditions is most commonly associated with these lab findings? A. Acute pancreatitis B. Chronic pancreatitis C. Adenocarcinoma of the pancreas D. Islet cell tumor E. Mets to the pancreas
answer
A.
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You are scanning a patient with a history of alcohol abuse and liver cirrhosis. The pancreatic tissue is heterogeneous. Calcifications and dilation of the pancreatic duct is present. Which condition is most likely considering this history and findings? A. Acute pancreatitis B. Chronic pancreatitis C. Adenocarcinoma of the pancreas D. Islet cell tumor E. Mets to the pancreas
answer
B. (chronic pancreatitis is associated with a heterogeneous echo texture and multiple calcifications throughout the gland. Frequently, calcifications may be seen with the duct. Dilatation of the duct is typical. Fibrotic masses that are easily confused with cancer can occur with chronic pancreatitis.)
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You have been asked to perform an US study on a patient with a pancreatic transplant. What chronic condition does this patient probably have? A. Crohn's disease B. Chronic pancreatitis C. Lymphoma D. Type 1 diabetes mellitus E. Lupus
answer
D. (Pancreatic transplants are performed to decrease insulin dependency and microvascular complications in patients with diabetes. Combined pancreatic and renal transplants may be done in these patients when renal failure complicates diabetes.)
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Where should you look for the pancreas in a patient with a pancreatic transplant? A. Pouch of Douglas B. Morrison's Pouch C. LUQ D. Iliac fossa E. Epgastrium
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D.
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Which of the following would be an indicator of pancreatic transplant rejection? A. high resistance Doppler signals B. Low resistance Doppler signals C. Heterogeneous parenchyma D. A & C E. B & C
answer
D. (Rejection of the pancreatic transplant is associated with high resistance Doppler signals and increased heterogenecity of the gland. Complications associated with transplant include vascular thrombosis, pseudoaneurysm, arterovenous fistula, and pancreatitis. Fluid collections that may be detected include urinoma, hematoma, and inflammatory collections associated with pancreatitis.)
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A nonencapsulated collection of necrotic and edematous peripancreatic tissues is termed: A. Phlegmon B. Pseudocyst C. Pseudoaneurysm D. Ascites E. Cystadenoma
answer
A.
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What is the most common cause of acute pancreatitis? A. Obstruction of the pancreatic duct by biliary calculi B. Pancreatic divisum C. Alcohol abuse D. Trauma E. Crohn's disease
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A. (the second most common cause is alcohol abuse)
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Surgery has requested US guidance to excise an insulinoma. What transducer would be best for this application? A. 2.25 MHz curved array B. 3.5 MHz curved array C. 5.0 MHz curved array D. 7.0 MHz curved array E. 10 MHz linear array
answer
E. (10 MHz linear array)
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You have documented the presence of a pseudocyst adjacent to the pancreatic head in a 56 yo male. Pseudocysts may be associated with which of the following? A. Acute pancreatitis B. Chronic pancreatitis C. Pancreatic cancer D. A & B only E. All of the above
answer
E.
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What is the relationship of the SMA to the pancreas? A. Posterior to the tail B. Posterior to the neck C. Superior to the body D. Cephalad to the head E. lateral to the tail
answer
B
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You have been asked to rule out pseudocyst formation in a patient with acute pancreatitis. What is the US appearance of a pancreatic pseudocyst? A. Cyst without internal echoes B. Cyst with low level echoes C. Cyst with internal septations D. Well defined wall E. All of the above
answer
E.
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You are performing an US on an obese patient and notice a small, hypoechoic tumor located in the tail of the pancreas. This most likely represents: A. Adenocarcinoma B. Cystadenocarcinoma C. Insuliinoma D. Klatskin tumor E. Pancreaticoblastoma
answer
C. (the most common type of islet cell tumor is insulinoma. Insulinomas are usually benign and present in the 4th through 6th decades of life. The presenting symptom is usually hypoglycemia. They most commonly occur as solitary tumors in the body and tail of the pancreas, although multiple tumors occur in about 10% of cases. Sonographically, they appear as well defined hypoechoic lesions. They are usually small and may be difficult to detect because they are small and the patient typically is obese.)
question
Which of the following is not correct about acute or chronic pancreatitis? A. Occurs when pancreas becomes damaged B. malfunctions from increased secretion C. Blockage of ducts D. Ruptured pancreatic vessels E. pancreatic tissue may be digested by its own enzymes
answer
D
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Usually only lasts a few days. A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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Caused by inflamed acinic cells releasing enzymes into the surrounding pancreatic tissue A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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An inflammatory process that spreads along fascial pathways causing areas of inflammatory soft tissue edema A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
C
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Rapid progression of acute pancreatitis A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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The most common cause is biliary tract disease A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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Will spread outside the gland 18-20% of the time A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
C
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Gallstone pain is usually the primary symptom A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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You have a patient with leukocytosis, increased Bilirubin, elevated Amylase and elevated Lipase. Patient has nausea, abdominal distention and fever. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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You are doing an US exam on a patient and find inflammatory soft tissue edema that is necrosed that has spread into the lesser sac and left pararenal space. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
C
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On US you find the pancreas that has focal enlargement that is more hypoechoic with irregular borders. The enlarged head is causing IVC compression. The pancreatic duct is enlarged. The patient also has gallstones. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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A patient comes in with a hx of surgery for an ulcer 1 week ago. The patient has a tender abdomen, growing abdominal mass, fever and chills. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
D
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A patient comes in with a hx of back pain, nausea and vomiting for 1 week. Labs show an elevated Lipase. On US the pancreas is diffusely enlarged with decreased echogenicity. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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On US exam you find the pancreatic ducts obstructed with protein plugs and calcification. The pancreas appears irregular, nodular or fibrous appearance. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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A 37 year old male with AIDS presents with hepatosplenomegaly and peripancreatic adenopathy. What type of pancreatitis do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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A patient comes in with chronic pain, nausea and vomiting, jaundice, weight loss that is developing Diabetes. What do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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What is the most common complication of Acute Pancreatitis? A. Pseudocysts B. Phlegmons C. Abscesses D. Hemorrhage E. Duodenal Obstruction
answer
B (Pseudocysts - 10%, Phlegmons - 18%, Abscesses - 1-9%, Hemorrhage - 5%)
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You have a male patient come in with pancreatitis. He has hypercalcemia and lyperlipidemia. He is a heavy drinker. What type pancreatitis do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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A 9 year old patient comes in with pancreatitis. The US exam shows the left lobe of liver is larger, the pancreas is isoechoic, enlarged with an indistinct outline. He has a history of a MVA 1 week ago. What type pancreatitis do you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
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A patient comes in for US. You notice Grey Turner's sign. What type pancreatitis would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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On US you find the pancreas calcifying with duct dilation. There is increased echogenicity of pancreas. It is smaller with irregular borders. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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A patient comes in with intense, severe pain radiating to the back, Ileus, shock, decreased hematocrit. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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On US you find a poorly defined hypoechoic mass in the pancreas. The patient has hypotension and Leukocytosis. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
D
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A 47 year old male alcoholic comes in with hypercalcemia and hyperlipidemia. It is noted in his history of previous bouts of pancreatitis? The exam shows progressive destruction of pancreatic tissue. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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A patient comes in after drinking a bottle of Gin. The US exam shows focal areas of fat necrosis. What type pancreatitis would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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Which type of pancreatitis is progressive and irreversible? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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A patient comes in with intense pain, Ileus and a decreased hematocrit. The US exam shows a well defined homogeneous mass in the area of the pancreas. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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On US exam you find an irregular shaped pseudocyst in the retroperitoneal cavity. The pancreas is enlarged and hypoechoic from fresh clot. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
B
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On US exam you find pus in the lesser sac and left pararenal space. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
C
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On US exam you find signs of infection. What else would you look for? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
D
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On US you find a dilated CBD and splenic vein thrombus with PV extension. What would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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Which type of pancreatitis can develop into pancreatic cancer? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
E
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What type of cyst can develop as a result of trauma, Acute or Chronic Pancreatitis? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
A
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What would you suspect if you noted multiple cysts in pancreas and liver of varying sizes that have an epithelial lining? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
B
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What would you suspect in a patient with nonspherical cysts that appear as a sterile abscess? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
A
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What would you suspect in a patient that has retinal hemangioblastoma, RCC and multiple cysts in the pancreas? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
C
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What would you suspect in a patient that has excessive production of thick mucus. The pancreas has fatty infiltration with cacifications. The ducts are obstructed. A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
D
question
A patient comes in for US with a history of having multiple cysts in the pancreas. Comparing this exam to the previous exam of 2 years ago you find the amount of cysts have increased. What would you suspect? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
B
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The most common pancreatic anomly is fatty infiltration. What does this describe? A. Pseudocysts B. Autosomal Dominant Polycystic Disease C. Von Hippel-Lindau Disease D. Cystic Fibrosis E. Solitary Pancreatic Cysts
answer
D
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Which type of cysts effects middle aged to elderly males and has a squamous lining? A. True cyst B. Lymphoepithelial cysts C. Pseudocyst D. Cystic Fibrosis E. Von Hippel-Lindau Disease
answer
B
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Which type of cyst is congenital or acquired? A. True cyst B. Lymphoepithelial cysts C. Pseudocyst D. Cystic Fibrosis E. Von Hippel-Lindau Disease
answer
A
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Which cyst contains enzymes and is generally directly in the pancreatic area? A. True cyst B. Lymphoepithelial cysts C. Pseudocyst D. Cystic Fibrosis E. Von Hippel-Lindau Disease
answer
A
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Which cysts are acquired and present as multiple cysts? A. True cyst B. Lymphoepithelial cysts C. Pseudocyst D. Cystic Fibrosis E. Von Hippel-Lindau Disease
answer
C
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What is the most common primary neoplasm of the pancreas? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
E
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Serous Cystadenoma is AKA? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
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Which tumor produces a large amount of mucin creating a cystic appearance? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
A
question
Which tumor accounts for >90% of all malignant pancreatic tumors? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
E
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A colloid Carcinoma is AKA? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
A
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Which tumor effects middle aged to elderly female with a large mass with multiple tiny cysts? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
Cystadenoma, Cystadenocarcinoma and Macrocystic Adenoma are all considered what type of tumor? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
C
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Cystadenoma, Serous Adenoma, Glycogen-Rich Adenoma are all considered what type of tumor? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
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Ductectatic Cystadenoma, Cystadenocarcinoma, Ductectatic Mucinous Tumor are all considered what type of tumor? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
D
question
What would you suspect in a patient that has solid mass with irregular borders, located in the head, an enlarged GB and CBD, a dilated pancreatic duct? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
E
question
If you discover an Adenocarcinoma what is the most important next step?
answer
Examine surrounding organs for mets and enlargement
question
On US exam you find an enlarged spleen with compressed splenic vein, compressed IVC, enlarged GB and CBD. What would you suspect the mass in the head of the pancreas is? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
E
question
Which of the following are benign tumors? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
Which of the following produces well defined cysts with thick mucinous fluid or internal septations? A. Mucinous Adenocarcinoma B. Macrocystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
Which of the following produces a large mass with multiple tiny cysts? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
A 50 year old female presents with a well defined mass in the tail of the pancreas. The fluid is very mucinous. What would you suspect? A. Mucinous Adenocarcinoma B. Macrocystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
What would you suspect in a 50 year old female that presents with a large mass with multiple tiny cysts? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
What would you suspect in a 50 year old female that has multiple cysts about 1.5 cm that has thick walls and appear similar to pseudocysts? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
An US exam on a 55 year old female shows a large cyst that arises from the ducts. The cyst is irregular and lobulated with thick walls. She has a history of Diabetes, biliary tract calculous and hypertension. What do you suspect? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
C
question
A patient comes in with a history of Von Hippel-Lindau disease. She has a single small cyst with thick walls. What do you suspect? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
B
question
A 60 year old female patient comes in with epigastric pain, a palpable mass and Diabetes. The US exam shows a large cyst with thick walls on the pancreatic duct. What would you suspect? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
C
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A patient comes in with an elevated serum amylase. On US exam you find the Wirsung duct to be dilated. What would you suspect? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
answer
D
question
Endocrine tumors arise from the A. Islets of Langerhans B. Acini Cells
answer
A
question
What would you suspect if you found small tumors in the tail of the pancreas? A. Lymphoma B. Mets C. Endocrine Neoplasms
answer
C
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Insulinoma and gastrinomas are types of what pancreatic tumor? A. Parapancreatic neoplasm B. Metastatic Disease C. Endocrine Neoplasm D. Lymphoma
answer
C
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What is the most common functional tumor?
answer
Insulinoma
question
Which functional tumor is usually malignant?
answer
Gastrinoma
question
Which functional tumor is associated with hyperinsulinism and hypoglycemia? A. Gastrinomas B. Insulinoma
answer
B
question
Which functional tumor is associated with peptic ulcer disease in young adults? A. Gastrinomas B. Insulinoma
answer
A
question
Which type of Islet Cell Tumors are very slow growing? A. Functional B. Nonfunctional
answer
B
question
Where do mets usually spread from?
answer
Melanomas, breast, gastrointestinal and lung
question
Which of the following is not a risk factor for developing primary pancreatic cancer? A. Smoking B. high fat diet C. Diabetes D. Acute Pancreatitis E. Prior Peptic Ulcer Surgery
answer
D
question
Which of the following is not a risk factor for developing primary pancreatic cancer? A. Chronic Pancreatitis B. Prior Peptic Ulcer Surgery C. High Carb Diet D. Cholecystectomy E. Occupational exposures
answer
C
question
What is the most frequent parapancreatic neoplasm?
answer
Lymphoma
question
What would you suspect is a patient that has SMA displacement and multiple nodules , hypoechoic with necrotic areas that appear cystic? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Lymphoma E. Adenocarcinoma
answer
D
question
If the Amylase level is double what would you suspect? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
answer
A
question
If the Lipase level is elevated what would you suspect?
answer
pancreatic disease
question
If the Glucose level is increased what would you suspect?
answer
severe diabetes, chronic liver disease, overactive endocrine glands
question
What is the most common complication of a pseudocyst?
answer
Rupture
question
What is the most common cystic lesion of the pancreas?
answer
Pseudocyst
question
Mucinous cystadenoma/cystadenocarcinoma is what type of tumor? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Macrocystic Adenoma D. Mucinous Cystic Tumor E. Intraductal Papillary Mucinous Tumor
answer
C
question
Mucinous Cystadenoma/Cystadenocarcinoma is AKA?
answer
Macrocystic Adenoma
question
Lymphoma is what type of neoplasm? A. Metastatic B. Endocrine Pancreatic Neoplasm C. Cystic Pancreatic Neoplasm D. Exocrine Pancreatic Lesion E. Parapancreatic Neoplasm
answer
E
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The most common location of pancreatic pseudocyst A. Lesser sac B. Porta hepatic area C. Groin D. Splenic hilum E. Mediastinum
answer
A
question
If a mass in the area of the pancreatic head is found, what other structure should be examined sonographically? A. The liver B. The IVC C. The spleen D. The kidney E. The bowel
answer
A. (when a mass is visualized in the area of the head , one should check for mets to the liver and dilation of the intrahapatic ducts. The CBD and Wirsung duct may be dilated secondary to obstruction caused by enlargement of the mass.)
question
The most common primary carcinoma of the pancreas A. Insulinoma B. Cystadenocarcinoma C. Adenocarcinoma D. Pancreatic pseudocyst E. Lymphoma
answer
C
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Obstructive jaundice may be diagnosed sonographically by demonstrating A. A mass of the head of the pancreas with dilated CBD B. An enlarged liver C. A fibrotic and strophic liver D. Chola titis E. Portal hypertension
answer
A
question
An ab US is performed and there is a suggestion of a mass in the head of the pancreas. Identify the other structures that should be evaluated. A. The biliary system and GB to evaluate biliary obstruction B. The hepatic artery and splenic artery to document dilation C. The kidney to evaluate renal obstruction D. Liver to evaluate focal masses E. Spleen to document size
answer
A. (when there is extrinsic pressure and obstruction of the CBD, the GB and biliary tree will be enlarged)
question
Identify the lab values which are most consistent for a patient with acute pancreatitis A. Creatinine and BUN will both rise, but creatinine remains higher for a longer period of time B. Amylase and alk phos will both rise, but amylase remains higher for a longer period of time C. Amylase and lipase rise at the same rate, but lipase remains higher for a longer period of time D. Insulin and glucose will both rise,, but glucose will remain higher for a longer period of time E. Epinephrine and norepinephrine will both rise and stay elevated for the same period of time
answer
C
question
Islet cell tumors Of the pancreas are most likely to be located in the pancreatic A. Head and neck B. Neck and tail C. Uncinate process D. Body and tail E. Head and body
answer
D
question
The most common primary Neoplasm of the pancreas is A. Adenocarcinoma B. Insulinoma C. Pseudocyst D. Cystadenoma E. Congenital cyst
answer
A
question
A 35 year old male presents with RUQ pain and recurrent attacks of pancreatitis. His lab results could indicate A. Increase in BUN B. Decrease in serum amylase C. Increased lipase D. Increase in direct bilirubin E. Increase in alk phos
answer
C
question
Obstruction of the CBD by a mass in the head of the pancreas will lead to? A. Dilated GB with dilated biliary radicles B. Contracted GB with dilated biliary radicles C. Dilated biliary radicles with normal or shrunken GB D. Portal hypertension E. Cirrhosis
answer
A
question
What is the most common islet cell tumor? A. Adenocarcinoma B. Pseudocyst C. True cyst D. Insulinoma E. Gastrinoma
answer
D
question
The most common complication of a pancreatic pseudocyst is A. Infection B. Reabsorption C. Calcification D. Hemorrhage E. Rupture
answer
E
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