Gastroenterology & Hepatology — Flashcards

Flashcard 561: What is the management in pancreatic cancer of the head where the tumour can be resected? _____

Answer: Whipple's procedure (pancreaticoduodenectomy) with adjuvant chemotherapy

Flashcard 562: Patients with small bowel obstruction should be nil _____

Answer: by mouth

Flashcard 563: Acute pancreatitis classically presents with _____ pain that may radiate to the back

Answer: severe epigastric

Flashcard 564: On CT scan a "_____" sign is indicative of pancreatic cancer

Answer: double duct

Flashcard 565: Acute pancreatitis is usually caused by: _____ alcoholism (30%)

Answer: gallstones (50%)

Flashcard 566: A patient presenting with large bowel obstruction may have a HPx of _____ and/or change in bowel habit

Answer: rectal bleeding

Flashcard 567: What is the investigation of choice for pancreatic cancer? _____

Answer: High resolution CT scan

Flashcard 568: Pathogenesis of acute pancreatitis involves autodigestion of pancreatic parenchyma by prematurely activated enzymes. Two most common causes: _____ Mechanism of Hemorrhage: Elastase digests blood vessel walls, potentially leading to Grey Turner's sign (flank ecchymosis). Mechanism of Fat Necrosis: Lipase breaks down peripancreatic fat, which then undergoes saponification with calcium.

Answer: Gallstones and Alcohol

Extra: Amylase and lipase are released into the bloodstream following acinar cell injury. Grey Turner's sign (flank) and Cullen's sign (periumbilical) indicate retroperitoneal hemorrhage and severe necrotizing pancreatitis.

Flashcard 569: Is pancreatic cancer always painless? _____

Answer: No → it can often present with pain that radiates to the back

Flashcard 570: Large bowel obstruction presents with abdominal pain, _____ and abdominal distenion

Answer: absolute constipation