GASTROENTEROLOGY ARTICLE OF THE WEEK
October 11, 2007
Witt H, Apte MV, Keim V, Wilson JS. Chronic pancreatitis: Challenges and advances in pathogenesis, genetics, diagnosis and therapy. Gastroenterology 2007;132:1557-1573.
1. Likely theories that may explain the pathophysiology of alcohol damage of the pancreas include
a. Protein precipitation in small pancreatic ducts
b. Altered sphincter of Oddi response to alcohol intake
c. Fatty acid ethyl esters effects on pancreatic acinar cells
d. Alcohol effects on pancreatic microcirculation
2. The highest risk of pancreatic cancer in patients with chronic pancreatitis is found in patients with:
a. alcoholic pancreatitis
b. autoimmune pancreatitis
c. hereditary pancreatitis
d. tropical pancreatitis
3. Prominent lymphocytic and plasma cell infiltrate is most commonly seen in
a. gallstone pancreatitis
b. tropical pancreatitis
c. autoimmune pancreatitis
d. any type of chronic pancreatitis
True of False
4. Pancreatic stellate cells probably play a major role in pancreatic fibrosis
5. A person with recurrent episodes of pancreatitis but normal ERCP does not have chronic pancreatitis
6. Autoimmune pancreatitis usually presents in patients age 30-40 years.
7. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene may explain some of the cases of idiopathic chronic pancreatitis.
8. In alcoholic pancreatitis, exocrine and endocrine insufficiency usually develops sooner than in other types of pancreatitis
9. The initial attack of alcoholic pancreatitis always occurs in the setting of an already damaged pancreas
10. The secretin stimulation test is the gold-standard for the detection of exocrine pancreatic insufficiency.
11. A mutation in the cationic trypsinogen gene or serine protease 1 gene (PRSS1) plays a role in cases of hereditary pancreatitis.
12. EUS can reliably diagnose chronic pancreatitis in patients with normal ERCP