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Gastro > Acute & chronic pancreatitis > Flashcards

Acute & chronic pancreatitis Flashcards

1
Q

What are the 2 types of cells found in the pancreas?

A

Acinar cells

Islet of langerhan cells

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2
Q

Where is the pancreas located?

A

in the upper abdomen next to the duodenum

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3
Q

Which pancreatic cells are involved in exocrine functions?

A

Acinar cells

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4
Q

Which pancreatic cells are involved in endocrine functions?

A

Islet of langerhan cells

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5
Q

What enzymes of acinar cells screte (pancreas)

A

Digestive enzymes

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6
Q

Give 3 examples of digestive enzymes secreted by acinar cells?

A

Protease
lipase
amylase

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7
Q

Give 3 examples of hormones secreted by islet of langerhan cells?

A

insulin
glucagon
somatostatin

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8
Q

in acute pancreatitis is the the onset of inflammation?

A

sudden inflammation

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9
Q

What does sudden inflammation of the pancreases cause in acute pancreatitis?

A

Auto digestion of the pancrease

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10
Q

What kind of damage is characteristic in acute pancreatitis?

  1. reversible
  2. irreversible
A
  1. reversible
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11
Q

what are the 2 common causes of acute acute pancreatitis?

A
  1. gall stones

2. excess alcohol consumption

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12
Q

Who is most likely to present with gall stone pancreatitis?

A

White women >60 yrs

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13
Q

Who is most likelt to present with alcohol pancreatitis?

A

Young male

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14
Q

What is the most common cause worldwide of acute pancreatits?

A

excess alcohol consumption

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15
Q

What is the acronym for the aetiology of acute pancreatitis and what does it stand for?

A

GET SMASHED

gall stones
ethanol (alcohol)]
trauma

steroids 
measles/malignancy 
autoimmune 
scorpion sting
high triglycerides and calcium
ercp (investigation and treatment)
drugs
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16
Q

What is suggested to cause premature enzyme activation and release in pancreatitis?

A

abnormal intracellular calcium

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17
Q

What does acinar cell injury promote pancreatitis?

A

inflammation and migration of inflammaotry cells

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18
Q

What can systemic/local inflammation of the pancreases cause as a result?

A

multiple organ failure

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19
Q

What are the 3 diagnostic criteria needed for diagnosis of acute pancreatitis?

A
  1. upper abdominal pain
  2. high serum lipase/amylase
  3. consisting imaging

2/3 required

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20
Q

What are the 5 F’s risk factors for gallstones?

A 
fat 
female
fertile
fair
40
21
Q

When taking a history of someone with acute pancreatitis what is important to rule out?

A

family history of hereditary pancreatitis

medication that cause pancreatitis as consequence

22
Q

What type of pain does a patient with acute pancreatitis complain of and where does it radiate to?

A

severe epigastric/LUQ pain

radiates to the back

23
Q

when does the pain of a patient with acute pancreatitis hurt most?

A

when lying flat or with movement

24
Q

Give 5 symptoms a patient with acute pancreatitis might complain of/present with?

A 
nausea 
vomiting 
malabsorption 
ascites 
steatorrhoea
fever 
taccycarid
Abdo pain 
jaundice 
high HR
low BP
anorexia
25
Q

What is the cullens sign and what does it indicate?

A

Bluish discolouration around the belly button and as a result of retroperitoneal haemorrhage

26
Q

What is the Grey turners sign and what does it indicate?

A

Bluish discolouration on the flanks and as a result of retroperitoneal haemorrhage

27
Q

What would blood tests of someone with acute pancreatitis indicate?

A

elevated serum lipase and amylase

28
Q

What will an ultrasound of someone with acute pancreatitis indicate?

A

gallstones

necrosis

abnormality

29
Q

Give examples of 4 complications associated with acute pancreatitis?

A 
chronic pancreatitis
pancreatic ascities 
pancreatic effusion 
acute renal failure 
infection 
fatty necrosis
30
Q

How would you manage a patient with acute pancreatits?

A 
IV saline 
morphine and O2
NIL by mouth
allow pancreas to rest 
Remove gall stones 
change diet- avoid fatty food and alcohol
31
Q

What type of inflammation is characteristic of chronic pancreatitis?

A

recurrent/persistent chronic inflammation

32
Q

What type of damage is characteristic of chronic pancreatitis?

A

irreversible

33
Q

what is chronic pancreatitis associated wit h increased risk fo developing?

A

pancreatic carcinoma

34
Q

what are 2 causes of chronic pancreatitis?

A

excessive alcohol consumption

cystic fibrosis

35
Q

How can CF cause chronic pancreatitis?

A

low bicarb production causes thick mucous that blocks the the ducts

36
Q

Give examples of 4 risk factors associated with chronic pancreatis?

A

family history
alcohol
smoking
coeliac disease

37
Q

What type of pain does a patient with chronic pancreatitis complain of and when is it triggered?

A

severe epigastric/LUQ pain

radiates to the back

triggered after eating

CAN BECOME AYSYMPOTOMATIC OVER TIME

38
Q

why might a patient with chronic pancreatitis present with anorexia and weight loss?

A

due to reduce food intake and excess alcohol consumption and malabsorption

39
Q

What is the word for fat present in faeces

A

statorrhoea

40
Q

What is a differential diagnosis of chronic pancreatitis that presents with weight loss?

A

pancreatic carcinoma

41
Q

When should pancreatic carcinoma be considered

A

short history

abnormalities on imaging

42
Q

How does lipase and amylase present in a patient with chronic pancreatitis?

43
Q

what is persons glucose level like that is suspected of chronic pancreatits?

44
Q

what 3 findings can be found on the CT scan of a person with chronic pancreatits?

A

calcification
diffuse/enlargement
ductal dilatation

45
Q

What lifestyle modifications can be made to treat chronic pancreatitis?

A

avoid fatty food

avoid alcohol and smoking

46
Q

What medications can be used to treat pancreatits?

A

pancreatic enzymes

omeprazole

47
Q

how would you treat pain of a patient suffering from chronic pancreatitis?

48
Q

How would you confirm the diagnosis of chronic pancreatitis?

A

imaging to look for structural changes

Gastro (11 decks)

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