Risky Business
This disease increases the risk of pancreatic adenocarcinoma 5-10 fold.
What is chronic pancreatitis?
Phillip is diagnosed with stage II pancreatic cancer. Which is the preferred treatment?
What is Pancreaticoduodenectomy (aka Whipple procedure)?
Marge, currently with an unrealized pancreatic cancer, develops these on her lower shins which appear as red, swollen, tender lines that reoccur.
What are migratory thombophlebitis (aka Trousseau Sign)?
This initial imaging test for pancreatic cancer is better at detecting smaller tumors and more useful for staging.
What is CT abdomen w/wo contrast?
This syndrome increases the risk of insulinoma, glucagonoma, gastrinoma, and VIPoma?
What is Multiple Endocrine Neoplasia (MEN) type 1?
Gigi is diagnosed with stage IV gallbladder chancer. This is the preferred management at this time.
What is chemotherapy (palliative)?
Hospice as well.
Groundskeeper Willie is found to have a palpable mass in the rectal pouch that later turns out to be a metastatic pancreatic tumor. The physical exam finding is commonly known as this.
What is Blumer's shelf?
Glenda c/o RUQ pain and involuntary weight loss x 6 months. An ultrasound shows a calcified gallbladder wall which is also known as this.
What is porcelain gallbladder?
This is the primary risk factor for cholangiocarcinoma.
What is Primary Sclerosing Cholangitis (PSC)?
Calvin is diagnosed with cholangiocarcinoma in situ. This is *potentially* curative.
What is surgical resection?
Homer develops vague RUQ abdominal pain, involuntary weight loss, jaundice, fever. Of GI malignancies, his presentation is most consistent with these two.
What are hepatocellular carcinoma and cholangiocarcinoma?
These two imaging studies can tell the distinctive vascular findings of a hepatocellular carcinoma, and either can make the diagnosis.
What are contrast CT and contrast MRI?
During surveillance of her child-pugh B cirrhosis, Harriet is diagnosed with a 3cm and 2cm malignant primary liver tumors in the left and right lobe respectively . Workup reveals no evidence of spread. based on this information, this is the preferred treatment(s).
What is a liver transplant?
Because of the increased risk, patients with one of these three liver diseases should undergo surveillance for the development of liver cancer.
Zander is diagnosed with ZES. While awaiting surgical resection, this should be given for management.
What is high dose PPI (i.e. Omeprazole 60-120mg)?
Mr. Burns presents for systemic pruritus. He looks yellow. On physical exam, the gallbladder is palpably distended but nontender. The gallbladder finding is known as this.
What is Courvoiser's sign?
This is used to confirm a ZES diagnosis in a patient with a gastrin level >150 pg/mL.
What is a secretin test?
These are three of the risk factors associated with gallbladder cancer.
What are cholelithiasis, porcelain gallbladder, GB polyps, Salmonella typhi (chronic), Primary Sclerosing Cholangitis, obesity? (3 of 6)
These are three alternatives that may be considered when surgical resection or liver transplant can't be accomplished for a patient with hepatocellular carcinoma.
What are ablation (various types), embolization, external beam radiation, chemotherapy + molecular targeted therapy (such as Sorafenib)?
(need 3 of the 4)
Ned Flanders has repeatedly been treated for peptic ulcer disease with non-sustained improvement. He also reports watery diarrhea. An in-office hemoccult turns blue and his lab draw demonstrates a decreased Hgb. H. pylori is negative. Of the GI malignancies, the presentation is most consistent with this.
What is Zollinger-Ellison Syndrome (aka gastrinoma)?
After diagnosis of pancreatic carcinoma, Prianka has this tumor marker drawn, AND we expect results to be above this U/mL.
What is CA-19-9, greater than 100?