Pancreatic pathology
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
A
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
A
A colloid Carcinoma is AKA? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
A
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
A
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
A
Endocrine tumors arise from the A. Islets of Langerhans B. Acini Cells
A
Gallstone pain is usually the primary symptom A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
A
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
A
The most common cause is biliary tract disease A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
A
Usually only lasts a few days. A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
A
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
A
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
A
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
A
Which functional tumor is associated with peptic ulcer disease in young adults? A. Gastrinomas B. Insulinoma
A
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
A
Which type of cyst is congenital or acquired? A. True cyst B. Lymphoepithelial cysts C. Pseudocyst D. Cystic Fibrosis E. Von Hippel-Lindau Disease
A
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
A
A nonencapsulated collection of necrotic and edematous peripancreatic tissues is termed: A. Phlegmon B. Pseudocyst C. Pseudoaneurysm D. Ascites E. Cystadenoma
A.
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
A.
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
A.
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
A. (Adenocarcinoma is the most common form of pancreatic cancer and is most commonly located in the head of the pancreas.)
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
A. (the second most common cause is alcohol abuse)
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
B
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
B
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
B
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
B
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
B
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
B
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
B
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
B
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
B
Rapid progression of acute pancreatitis A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
B
Serous Cystadenoma is AKA? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
B
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
B
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
B
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
B
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
B
Which functional tumor is associated with hyperinsulinism and hypoglycemia? A. Gastrinomas B. Insulinoma
B
Which of the following are benign tumors? A. Mucinous Adenocarcinoma B. Microcystic Adenoma C. Mucinous Cystic Tumor D. Intraductal Papillary Mucinous Tumor E. Adenocarcinoma
B
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
B
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
B
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
B
Which type of Islet Cell Tumors are very slow growing? A. Functional B. Nonfunctional
B
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
B
What is the most common complication of Acute Pancreatitis? A. Pseudocysts B. Phlegmons C. Abscesses D. Hemorrhage E. Duodenal Obstruction
B (Pseudocysts - 10%, Phlegmons - 18%, Abscesses - 1-9%, Hemorrhage - 5%)
Which of the following is an endocrine tumor? A. Adenocarcinoma B. Islet cell tumor C. Cystadenocarcinoma D. Lymphangioma E. Pancreaticoblastoma
B.
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
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.)
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
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.)
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
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.)
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
C
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
C
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
C
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
C
Insulinoma and gastrinomas are types of what pancreatic tumor? A. Parapancreatic neoplasm B. Metastatic Disease C. Endocrine Neoplasm D. Lymphoma
C
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
C
What would you suspect if you found small tumors in the tail of the pancreas? A. Lymphoma B. Mets C. Endocrine Neoplasms
C
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
C
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
C
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
C
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
C
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
C
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
C.
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
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.)
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
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.)
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
D
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
D
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
D
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
D
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
D
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
D
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
D
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
D
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
D
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
D
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
D.
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
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.)
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
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.)
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
E
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
E
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
E
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
E
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
E
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
E
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
E
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
E
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
E
Which type of pancreatitis can develop into pancreatic cancer? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
E
Which type of pancreatitis is progressive and irreversible? A. Acute Pancreatitis B. Hemorrhagic Pancreatitis C. Phlegmonous Pancreatitis D. Pancreatic Abscess E. Chronic Pancreatitis
E
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
E
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
E
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
E.
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
E.
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
E.
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
E. (10 MHz linear array)
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
E. (risk factors include all listed as well as prior peptic ulcer surgery, cholecystectomy, and occupational exposure to benzidine and gasoline derivatives.)
If you discover an Adenocarcinoma what is the most important next step?
Examine surrounding organs for mets and enlargement
Which functional tumor is usually malignant?
Gastrinoma
What is the most common functional tumor?
Insulinoma
What is the most frequent parapancreatic neoplasm?
Lymphoma
Where do mets usually spread from?
Melanomas, breast, gastrointestinal and lung
