Acute & chronic pancreatitis

Question 1

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

Answer 1

Acinar cells

Islet of langerhan cells

Question 2

Where is the pancreas located?

Answer 2

in the upper abdomen next to the duodenum

Question 3

Which pancreatic cells are involved in exocrine functions?

Answer 3

Acinar cells

Question 4

Which pancreatic cells are involved in endocrine functions?

Answer 4

Islet of langerhan cells

Question 5

What enzymes of acinar cells screte (pancreas)

Answer 5

Digestive enzymes

Question 6

Give 3 examples of digestive enzymes secreted by acinar cells?

Answer 6

Protease
lipase
amylase

Question 7

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

Answer 7

insulin
glucagon
somatostatin

Question 8

in acute pancreatitis is the the onset of inflammation?

Answer 8

sudden inflammation

Question 9

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

Answer 9

Auto digestion of the pancrease

Question 10

What kind of damage is characteristic in acute pancreatitis?

1. reversible
2. irreversible

Answer 10

1. reversible

Question 11

what are the 2 common causes of acute acute pancreatitis?

Answer 11

1. gall stones

2. excess alcohol consumption

Question 12

Who is most likely to present with gall stone pancreatitis?

Answer 12

White women >60 yrs

Question 13

Who is most likelt to present with alcohol pancreatitis?

Answer 13

Young male

Question 14

What is the most common cause worldwide of acute pancreatits?

Answer 14

excess alcohol consumption

Question 15

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

Answer 15

GET SMASHED

gall stones
ethanol (alcohol)]
trauma

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

Question 16

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

Answer 16

abnormal intracellular calcium

Question 17

What does acinar cell injury promote pancreatitis?

Answer 17

inflammation and migration of inflammaotry cells

Question 18

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

Answer 18

multiple organ failure

Question 19

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

Answer 19

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

2/3 required

Question 20

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

Answer 20

fat 
female
fertile
fair
40

Question 21

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

Answer 21

family history of hereditary pancreatitis

medication that cause pancreatitis as consequence

Question 22

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

Answer 22

severe epigastric/LUQ pain

radiates to the back

Question 23

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

Answer 23

when lying flat or with movement

Question 24

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

Answer 24

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

Question 25

What is the cullens sign and what does it indicate?

Answer 25

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

Question 26

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

Answer 26

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

Question 27

What would blood tests of someone with acute pancreatitis indicate?

Answer 27

elevated serum lipase and amylase

Question 28

What will an ultrasound of someone with acute pancreatitis indicate?

Answer 28

gallstones necrosis abnormality

Question 29

Give examples of 4 complications associated with acute pancreatitis?

Answer 29

``` chronic pancreatitis pancreatic ascities pancreatic effusion acute renal failure infection fatty necrosis ```

Question 30

How would you manage a patient with acute pancreatits?

Answer 30

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

Question 31

What type of inflammation is characteristic of chronic pancreatitis?

Answer 31

recurrent/persistent chronic inflammation

Question 32

What type of damage is characteristic of chronic pancreatitis?

Answer 32

irreversible

Question 33

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

Answer 33

pancreatic carcinoma

Question 34

what are 2 causes of chronic pancreatitis?

Answer 34

excessive alcohol consumption | cystic fibrosis

Question 35

How can CF cause chronic pancreatitis?

Answer 35

low bicarb production causes thick mucous that blocks the the ducts

Question 36

Give examples of 4 risk factors associated with chronic pancreatis?

Answer 36

family history alcohol smoking coeliac disease

Question 37

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

Answer 37

severe epigastric/LUQ pain radiates to the back triggered after eating CAN BECOME AYSYMPOTOMATIC OVER TIME

Question 38

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

Answer 38

due to reduce food intake and excess alcohol consumption and malabsorption

Question 39

What is the word for fat present in faeces

Answer 39

statorrhoea

Question 40

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

Answer 40

pancreatic carcinoma

Question 41

When should pancreatic carcinoma be considered

Answer 41

short history abnormalities on imaging

Question 42

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

Answer 42

normal

Question 43

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

Answer 43

high

Question 44

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

Answer 44

calcification diffuse/enlargement ductal dilatation

Question 45

What lifestyle modifications can be made to treat chronic pancreatitis?

Answer 45

avoid fatty food | avoid alcohol and smoking

Question 46

What medications can be used to treat pancreatits?

Answer 46

pancreatic enzymes | omeprazole

Question 47

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

Answer 47

analgesia

Question 48

How would you confirm the diagnosis of chronic pancreatitis?

Answer 48

imaging to look for structural changes