acute/chronic pancreatitis

Question 1

endocrine function of the pancreas

Answer 1

insulin and glucagon production

Question 2

explain endocrine function

Answer 2

islets of Langerhans secrete several hormones directly into the blood stream

Question 3

exocrine function

Answer 3

enzyme secretion

Question 4

what cells produce enzymes

Answer 4

acinar cells

Question 5

how do the enzymes get to the food

Answer 5

pancreatic duct to the duodenum

Question 6

acute pancreatitis causes

Answer 6

I: idiopathic, G: gallstones, E: ethanol (alcohol), T: trauma, S: steroids, M: mumps, A: autoimmune, S: scorpion stings/spider bites, H:hyperlipidaemia/hypercalcaemia/hyperparathyroidism, E: ERCP, D: drugs

Question 7

examples of drugs causeing AP

Answer 7

azathioprine, oestrogens, corticosteroids, didanosine

Question 8

causes of CP

Answer 8

alcohol
Autoimmune (IgG4-related)
idiopathic
hereditory

Question 9

hereditory CP

Answer 9

CF

Question 10

final common pathway of AP

Answer 10

elevation in intracellular calcium = activation of intracellular proteases and release of pancreatic enzymes, acinar cell injury and necrosis follows = migration of inflammatory cells

Question 11

AP symptoms

Answer 11

upper epigastric pain which radiates to the back

nausea and vommitting

Question 12

AP signs

Answer 12

Cullen’s sign

Grey Turner’s sign

Question 13

what does cullens sign or grey turners sign mean

Answer 13

necrotizing pancreatitis

Question 14

Ecchymoses around the umbilicus

Answer 14

cullens

Question 15

Ecchymoses in the flanks

Answer 15

grey turners

Question 16

what in the blood test indicates AP

Answer 16

raised serum amylase or lipase

Question 17

test for perforated peptic ulcer

Answer 17

chest X ray

Question 18

AP complications

Answer 18

hyperglycaemia, hypocalcaemia, renal failure

and shock

Question 19

chronic pancreatitis pathophys

Answer 19

Inappropriate activation of enzymes in pancreas = protein plugs in duct lumen = nidus for calcification. Subsequent duct blockage = ductal hypertension + pancreatic damage, cytokine activation = pancreatic inflammation, irreversible morphological change and impairment of function

Question 20

clinical features of CP

Answer 20

intermittent or constant radiating through to
the back
weight loss
Diabetes 
steatorrhoea
jaundice

Question 21

why might you be jaundiced in CP

Answer 21

obstruction of the CBD

Question 22

Cancer affecting the head of the pancreas or ampulla of Vater clinical features

Answer 22

painless jaundice
weight loss
scratch marks
distended, palpable gall bladder
central abdominal mass

Question 23

Cancer of the body or tail clinical presentation

Answer 23

abdominal pain, weight loss, diabetes

Question 24

pancreas diagnosis is made with

Answer 24

US

contrast-enhanced spiral CT