GASTROENTEROLOGY ARTICLE OF THE WEEK
January 5, 2012
Vincent A, Herman J, Shculick R et al. Pancreatic Cancer. Lancet 2011;378:607-620.
1. Which of the following is (are) associated with an increased risk of pancreatic cancer:
a. Diabetes
b. Smoking
c. Metformin use
d. African American ethnicity
e. Group O blood
f. Coffee intake
2. The plural of pancreas is:
a. pancreas
b. pancreases
c. muchos pancreas
d. pancreata
e. pancreass
3. Resection of intraductal papillary mucinous neoplasms of the pancreas (IPMN’s) should be done if
a. the side branches are involved
b. it is larger than 1cm
c. Is associated with symptoms
d. The main pancreatic duct is involved
c. The mucinous neoplasm has a mural nodule
True or False
4. Preoperative levels of CA 19-9 >100-200 are predictive of unresectability and survival
5. PanIN’s (Pancreatic Intraepithelial Neoplasia) are the most common neoplastic precursor to invasive cancer and can be detected by EUS
6. Resection of IPMN should be strongly considered in patients with a family history of pancreatic adenocarcinoma.
7. BRAC2 gene mutation account for the highest proportion of known causes of inherited pancreatic cancer.
8. All patients with obstructive jaundice from pancreatic cancer should undergo biliary drainage prior to surgery.
9. Low molecular weight heparin is preferred to warfarin to prophylax against DVT in patients with pancreatic cancer
10. After surgery, the most common site of recurrence is local.
11. STK11 mutation associated with pancreatic cancer is most often found in Lynch Syndrome associated pancreatic cancer.
12. Progression from an initial neoplastic clone to clinically evident malignancy in pancreatic cancer takes 3 to 5 years
13. Biliary drainage is recommended for jaundiced patients who are going to undergo neoadjuvant chemo-radiation therapy
14. Serial determination of CA19-9 levels during chemoradiation therapy may be used to predict treatment response or disease relapse
15. Patients who undergo an R0 resection (no evidence of residual tumor) do not need adjuvant treatment.