PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a typical clinical presentation of pancreatic carcinoma?

1. Persistent abdominal pain without jaundice

2. Pain radiating to the back with jaundice

3. Frequent nausea without jaundice

4. Vomiting in the absence of pain

The correct answer is: Pain radiating to the back with jaundice

The typical clinical presentation of pancreatic carcinoma often includes pain radiating to the back combined with jaundice. This stems from the anatomical positioning of the pancreas and its relationship with surrounding structures. As the tumor grows, it can invade nearby organs or structures, leading to pain that is frequently described as dull or aching, and may radiate to the back. Jaundice occurs in many cases because the carcinoma can obstruct the common bile duct, which is situated close to the head of the pancreas. This obstruction prevents bile from flowing from the liver into the intestine, leading to the buildup of bilirubin in the blood and resulting in yellowing of the skin and eyes, a hallmark sign of jaundice. The combination of back pain and jaundice is characteristic and often prompts further investigation, typically imaging studies, which may reveal a mass in the pancreas. Recognizing this classical symptomatology is crucial for timely diagnosis and management of pancreatic cancer. In contrast, other options presented do not align with the typical clinical picture associated with pancreatic carcinoma. Persistent abdominal pain without jaundice may suggest other gastrointestinal or abdominal pathologies but is not specifically indicative of pancreatic cancer. Likewise, frequent nausea without jaundice or vomiting in the absence of pain are less characteristic of pancreatic cancer