Next best step in suspected pancreatic cancer

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Bagheera

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Hey everyone

I remember in one UWORLD question, it was do Ultrasound first, then CT scan. But another question , it was CT scan, and they didnt even mention ultrasound. these discrepancies make me unsure how to go about things on the real test since this a commonly tested topic

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If you really suspect pancreatic CA (weight loss, person >45 years, +/- jaundice), it is definitely CT scan first. Ultrasound first would be more if you have a high suspicion for gallbladder pathology, like in a case of pancreatitis in a non-alcoholic. Lots of UWORLD questions on this if I recall correctly!
 
No role for US in pancreatic cancer. Pancreatitis (to look for gallstones --> Gallstone pancreatitis) has an indirect role w/ US.

Painless jaundice, > 40 years old, smoker or hx of chronic pancreatitis/alcoholism = Abd. CT all day.
 
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