Cystic lesion of pancreas

Q) A 48-year-old female presents with an incidental imaging finding of a microcystic pancreatic lesion with a stellate scar. Cyst fluid analysis reveals low viscosity, CEA, CA 19-9, and amylase. These findings are most consistent with:
A. Serous cystic lesion
B. Mucinous cystic lesion
C. Intraductal pancreatic mucinous neoplasm
D. Pseudocyst

Hereditary pancreatic cancers

Hereditary pancreatic cancers questions is asked many times in NEET SS and GI and onco Surgery CET 

Please understand the difference between x% lifetime risk of pancreatic cancer and x fold increase in risk as compared to normal population

  1. PRSS & SPINK 1 - Familial pancreatitis 40% lifetime increase . 50 fold increase as compared to Normal
  2. STK 11 - Peutz Jeghers - 100 fold increase in Pancreatic cancer . Also associated with lung, ovarian, breast, uterine, and testicular cancers
  3.  CFTR - cystic fibrosis - 30 fold increase
  4. Familial atypical mole and multiple melanoma syndrome (CDKN2A gene mutation). CDKN2A - 20 fold increase
  5.  BRCA 2 - 10 fold increase
  6. Lynch Syndrome  ( MLH) ( MSH) - 8 fold increase
  7. FAP APC gene - 4 fold

Pancreatectomy

Q) Not true about pancreatectomy?

a) Antecolic reconstruction slows gastric emptying.

b) Drains are routinely used after pancreatic resections and currently standard of care.

c) Drains increase infections and prolong hospital stay.

d) Presence of drain fails to reduce the need for interventional radiology.

Amylase and Lipase in Acute pancreatitis

Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase

MCQs on Pancreatitis 

Q) Why does amylase and lipase increase in pancreatitis?

A) They are released from the acinar cells of pancreas during injury

Q) When does serum amylase rise in acute pancreatitis?

A) Within the first 12 hours

Amylase in pancreatitis

Q) In  acute pancreatitis all are true except :

1) Amylase is more sensitive for first 5 days than lipase

2) S. lipase remains elevated for a longer time

3) Amylase levels not included in definitive diagnostic criteria of acute pancreatitis

4) Amylase levels may not be elevated in 19 % of patients

 

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