Acute Chronic Pancreatitis/Celiac

Question 1

Acute pancreatitis: keys to treatment

Answer 1

-Early and aggressive IV fluid resuscitation

normal saline or lactated ringers

Question 2

What are the two main causes of acute pancreatitis?

Answer 2

1. Alcohol

2. Gallstones

Question 3

Medications that can cause acute pancreatitis?

Answer 3

• ACE, ARBS, Thiazide, Loops
• Antimetabolites (mercaptopurine and azathioprine)
• Corticosteroids
• Glyburide
• Mesalamine
• TMP-SMX
• HMG-CoA reductase inhibitors (esp. simvastatin)

Question 4

Chronic pancreatitis: presentation

Answer 4

• chronic pain (decrease in trypsin decreases ability to break down CCK, so loss of negative feedback)
• malabsorption with steatorrhea
• DM
• increased risk of pancreatic cancer

Question 5

Chronic pancreatitis: Tx

Answer 5

• pancreatic enzymes for malabsorption, decrease CCK release –>decreases pain (give during or just after meal)
• ->based on lipase***
• Reduce dietary fats
• Pain control (Tramadol)

Question 6

Celiac Disease: etiology

Answer 6

• Sensitivity to gliadin fraction in gluten
• Tissue transglutaminase (tTG) modified protein
• Villous atrophy**
• Malabsorption

Question 7

Celiac: Dx

Answer 7

(+) IgA tTG antibodies

Question 8

Celiac: Tx

Answer 8

• LIFELONG avoidance of gluten

- PNA vaccine, due to association with hyposplenism