Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            on in GB 
colicky pain 
worse with fatty food 
 
RUQ US /elective cholecystectomy 
Cholecystitis [2] 
Cystic duct obstruction 
 constant pain 
positive Murphy sign 
fever, leukocytosis 
RUQ US /emergency cholecystectomy 
 
Choledocholithiasis [3] 
Common Bile duct obstruction  
Proximal inflammation 
Obstructive jaundice 
Dilated hepatic bile ducts 
ERCP 
Cholangitis [4] 
Choledocholithiasis 
RUQ/ US 
emergency ERCP 
 
 
Takeaway points 
• Gallbladder pathology revolves around obstruction inflammation, 
infection, and malignancy. 
• Gallstones are common condition often asymptomatic and may cause 
biliary colic or causing complication 
• Acute cholecystitis is the most common complication of gallstones, its 
emergency condition requires urgent diagnosis and treatment.  
• Routine histological examination of cholecystectomy specimens is 
essential 
• Chronic cholecystitis increases the risk of gallbladder carcinoma 
which is rare but aggressive with late presentation and poor prognosis  
61 
 
 
 
 
Lecture 7: Pancreatic Pathology 
 
Intended Learning Outcomes (ILOs) 
By the end of this lecture, you will be able to: 
• Describe the normal structure and function of pancreas 
• Define acute and chronic pancreatitis and their causes, pathology and clinical 
presentation 
• Understand benign and malignant tumors of exocrine pancreas 
• Identify islet cell tumors of endocrine pancreas 
 
 Outline 
• Introduction 
• Acute pancreatitis 
• Chronic pancreatitis 
• Pancreatic exocrine tumors 
• Pancreatic endocrine tumors 
 
 
 
 
 
62 
 
Introduction to Pancreatic Structure and Function 
The pancreas is a vital organ with both exocrine and endocrine functions, playing a key 
role in digestion and metabolism. It is located in the retroperitoneum, extending from the 
duodenum to the spleen, and is divided into the head, neck, body, and tail. 
1. Exocrine Function: the majority (85-90%) of the pancreas consists of exocrine acinar 
cells, which produce digestive enzymes, including:( Proteases (trypsin, chymotrypsin) for 
protein digestion. Lipases for fat digestion., Amylase for carbohydrate digestion. These 
enzymes are secreted into the pancreatic ducts → main pancreatic duct → joins the bile 
duct at the ampulla of Vater → duodenum). 
2. Endocrine Function: The islets of Langerhans (1-2% of pancreatic tissue) contain 
hormone-producing cells: 
• β-cells (insulin) – regulate glucose uptake. 
• α-cells (glucagon) – increase blood glucose levels. 
• δ-cells (somatostatin) – inhibit hormone secretion. 
 
Diseases of exocrine pancreas 
• Cystic fibrosis 
• Congenital abnormalities 
• Acute and chronic pancreatitis 
• Neoplasms 
Diseases of endocrine pancreas 
• Diabetes 
• Neoplasms 
 
 
 
63 
 
Acute pancreatitis  
• Reversible inflammatory disorder varies in severity, from focal edema and fat 
necrosis to widespread hemorrhagic necrosis. 
• Caused by autodigestion of the pancreas by premature activation of pancreatic 
enzymes. 
• Early diagnosis and treatment 

            Quiz: