Answers to Questions Posted after Year 5 Pancreas and Gall Bladder Pathology Lecture.

How does Hyperlipidaemia result in pancreatitis? Good question, I had to look up the answer. There are 2 theories. The first is that the FFAs directly damage the pancreas and the second that chylomicrons cause increased plasma viscosity causing pancreatic ischemia,

how do these patients present? If you mean acute and/ or chronic pancreatitis, I refer you to any standard clinical textbook.

What’s the difference between a carcinoma and neoplasms? The term neoplasm includes both benign and malignant “new growths) A carcinoma is a malignant neoplasm of epithelial cells. It includes adenocarcinomas and squamous cell carcinoma.

On firms, someone presented a case where a patient had autoimmune pancreatitis, but with normal IgG4 plasma cell levels/serum IgG4 cells. Presumably this is not common, but is this likely to be related to the ‘IgG4 Related Diseases’ or another pathophysiology entirely? There are 2 types of auto-immune pancreatitis; type 1 is part of IgG4-RD and type 2 is not . It sounds like your case was an example of type 2.

What does the PAAN abbreviation stand for? I think you mean PanIN. This stands or Pancreatic Intra-epithelial Neoplasia.

Re Carcinoma of head of pancreas – does that mean they have better prognosis if diagnosed earlier? Or is timing irrelevant to prognosis? The earlier they present the less time there will have been for the cancer to spread. This will make it an earlier stage and early stage cancers have a better prognosis.

how do patients with igg4 related disease present? Wait until my lecture on Systemic Diseases! The pancreas is the commonest site but virtually any organ in the body can be involved.

Why are transplants not so successful in pancreatic cancer? Because they are an aggressive cancer and the immunosuppression for transplantation would mean the tumour would spread more quickly. The same is, of course, true for many other kinds of cancers.

Are thiazide diuretics directly noxious to pancreas or is it because they cause hypercalcaemia? Thiazides cause both hyperlipidaemia and hypercalcaemia either which can lead to pancreatitis

Where can I find your blog?

What textbooks would you recommend to be able to understand histopathology images better (and be able to know what we’re looking at). I think any of the standard undergraduate pathology textbooks would be fine. The latest edition of Muirs has just been published and is a good choice.

What practical do these diverticula have on management? Do you mean Rokitansky-Aschoff Sinuses in the gall bladder. If you do, then they have no impact on management – they are only identified when the gall bladder is removed.

Why is it so common in Chile? You are talking about gall bladder cancer The answer is, as ever, there are environmental (commoner as you go higher up the Andes) and genetic (commoner in the indigenous population).

Is alcohol not a drug? An interesting philosophical question. I think you are right but we tend to look at it separately as it very widely used, self-prescribed and not taken to treat disease.

paan is pancreatic atypical anaplastic neoplasia i’ve found out I am not sure that I understand this but see above. You can get anaplastic (undifferentiated) carcinomas in the pancreas as you can in any other organ,

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