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Pathology | Medicine (MD/DO) School Study Aid


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Pancreatic Disorders
15 Picmonics to Learn | 37 mins

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Annular Pancreas
Characteristics
Congenital Anomaly
Fusion of Ventral and Dorsal Pancreatic Buds
Circumferential Duodenal Compression
Associations
Down Syndrome
Clinical Features
Polyhydramnios
Poor Feeding
Vomiting
Diagnosis
Double Bubble Sign
Management
Surgery
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2 mins
Glucagonoma
Characteristics
Pancreatic Neuroendocine Tumor
Originates from A Cells
Clinical Features
Weight Loss
Necrolytic Migratory Erythema
Depression
Diarrhea
Deep Vein Thrombosis
Diabetes Mellitus
Diagnosis
Increased Glucagon
Abdominal CT
Management
Octreotide
Surgical Resection
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2 mins
Insulinoma
Characteristics
Pancreatic Neuroendocrine Tumor
Benign
Associated with MEN-1
Clinical Features
Whipple Triad
Symptoms of Hypoglycemia
Hypoglycemia During Episode
Relief with Glucose
Diagnosis
Increased C-peptide
Management
Surgery
Octreotide
Diazoxide
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2 mins
Acute Pancreatitis Assessment
Mechanism
Heavy Alcohol Use and Gallstones
Signs and Symptoms
Abdominal Pain
Nausea/Vomiting/Anorexia
Abdominal Rigidity/Guarding
Decreased or Absent Bowel Sounds
Hypotension and Tachycardia
Jaundice
Increased White Blood Cells
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2 mins
Acute Pancreatitis Disease
Autodigestion of Pancreas by Pancreatic Enzymes
Symptoms
Epigastric Abdominal Pain Radiating to Back
Anorexia
Nausea
Labs
Increased Amylase and Lipase
Complications
Disseminated Intravascular Coagulation (DIC)
Infection
Hypocalcemia
Systemic Inflammatory Response Syndrome (SIRS)
Acute Respiratory Distress Syndrome (ARDS)
Pancreatic Pseudocyst
Hemorrhage
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3 mins
Acute Pancreatitis Causes
"GET SMASHHED" Mnemonic
Gallstones
(Ethanol) Alcohol
Trauma
Steroids
Mumps
Autoimmune
Scorpion Sting
Hypercalcemia
Hypertriglyceridemia > 1000
ERCP
Drugs
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1 min
Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
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2 mins
Ranson's Criteria on Admission
Use
Mortality Predictor for Acute Pancreatitis
Criteria on Admission
GA LAW (Each is +1)
Glucose > 200 mg/dL
Age > 55 Years
LDH > 350 U/L
AST > 250 U/L
WBC Count > 16,000/mm3
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2 mins
Ransons Criteria During First 48 Hours
Use
Mortality Predictor for Acute Pancreatitis
Criteria Present at 48 Hours
C HOBBS (Each is +1)
Calcium < 8.0 mg/dL
Hematocrit Decreased by > 10%
Oxygen (PO2) < 60 mmHg
BUN Increased by Greater or Equal to 5 mg/dL
Base Deficit > 4 mEq/L
Sequestered Fluid > 6 L
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3 mins
Zollinger-Ellison Syndrome Disease
Pathophysiology
Gastrin-Secreting Tumor
Increased Gastric Acid
Recurrent Peptic Ulcers
MEN Type 1
Symptoms
Abdominal Pain
Heartburn (Pyrosis)
Diarrhea
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3 mins
Zollinger-Ellison Syndrome Diagnosis and Treatment
Diagnosis
Gastrin > 1000 pg/mL
Positive Secretin Stimulation Test
Treatment
High-Dose PPI
Octreotide
Surgical Resection
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3 mins
Pancreatic Adenocarcinoma Diagnosis and Treatment
Diagnosis
CA 19-9
Liver Function Tests for Cholestasis 
Serum Lipase
Ultrasound if Cholestasis Suspected
CT Abdomen
FNA Biopsy if Diagnosis or Resectability Uncertain
Treatment
Whipple if Resectable
Palliative Care if Not Resectable
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4 mins
Pancreatic Adenocarcinoma Symptoms and Risk Factors
Common Signs and Symptoms
Abdominal Pain
Anorexia and Weight Loss
Migratory Superficial Thrombophlebitis
New-Onset Diabetes
Signs/Symptoms Specific to Tumors in the Pancreatic Head
Jaundice
Steatorrhea
White Stool
Palpable but Non-tender Gall Bladder
Risk Factors
Elderly 
Chronic Pancreatitis
Smoking
Alcoholism
Diabetes
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5 mins
VIPoma
Characteristics
Pancreatic Neuroendocrine Tumor
Secretes Vasoactive Intestinal Polypeptide (VIP)
Clinical Features
GI Distress
Watery Diarrhea
Hypokalemia
Achlorhydria
Management
Octreotide
Surgical Resection
Associations
Multiple Endocrine Neoplasia Type 1 (MEN 1)
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2 mins
Somatostatinoma
Characteristics
Pancreatic Neuroendocrine Tumor
Originates from Delta Cells
Clinical Features
Steatorrhea
Gallstones
Hyperglycemia
Diagnosis
Increased Somatostatin
Abdominal CT or MRI
Management
Octreotide
Surgical Resection
Chemotherapy
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2 mins

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